We carried out an announced comprehensive inspection on 10 March 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Back Ground

Eastgate Dental Practice is a mixed dental practice providing both NHS and private treatment. The practice caters for children and adults and is situated in Rochester, Kent. The practice provides services on three split levels and has three treatment rooms, an OPG (Orthopantomograph – an oral x-ray machine), reception and two waiting areas.

The practice has five dentists (the principal dentist, three associates and a salaried dentist). The dentists are supported by seven dental nurses who have dual roles and act as receptionists, one of whom is the practice manager. Dental services are provided from Monday to Friday 9am to 5.30pm and on Saturdays from 9am to 1pm.

Before our inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of using the practice. We collected nine completed cards. All provided a positive view of the service the practice provides. We spoke with five patients who commented that the team were kind, caring, efficient and that they had received very good care. They all commented that the practice was very clean and that staff treated patients with dignity and respect. Patients told us they had sufficient time during consultations with staff and felt listened to as well as safe.

Our key findings were:

• Staff reported incidents and kept records of these which were used for shared learning and improvement.
• The practice was visibly clean and well maintained.
• Patients’ needs were assessed and care and treatment was planned and delivered in line with current guidance.
• The practice had effective safeguarding processes and staff understood their responsibilities for safeguarding vulnerable adults and children.
• The practice placed an emphasis on the promotion of good oral health and provided regular oral health advice to patients.
• Staff had received training appropriate to their role and were supported in their continued professional development.
• Information from nine completed comment cards gave us a positive picture of a friendly, caring, professional service.
• The practice took into account comments, suggestions or complaints and used these to make improvements to the service.
• Staff were well supported and were committed to providing a quality service to their patients.

There were areas where the provider could make improvements and should:

• Review the practice’s infection control procedures and protocols to ensure they are suitable giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

• Review the way in which clinical waste is disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Revise the practices processes to ensure there is an effective system to assess, monitor and mitigate the risks arising from fire safety requirements.

• Review the practice’s arrangements for informing staff of patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review the current legionella risk assessment, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Review the practice's recruitment policy and procedures to ensure that proof of identification are requested and recorded suitably, for all staff. As well as obtaining and recording a full employment history for existing employees.

• Review its complaint handling procedures and establish an accessible system for recording, handling and responding to verbal complaints by patients.

We visited Eastgate dental practice, we spoke with staff and the manager, looked at documentation, records and policies and procedures. We contacted people who used the service by phone following the visit to gain their view of the service.

People told us that before they received any treatment they had discussed this and the options available with the dentist. They had then been asked for their consent and the dentist acted in accordance with their wishes.

One patient said “The dentist explained my treatment and reasons for it to me at my visit”. Another patient said, “The dentist asked me before they carried out the treatment if I agreed to it, they are very good at explaining everything”.

There were effective systems in place to reduce the risk and spread of infection.

Appropriate checks were undertaken before staff began work.

There were suitable arrangements to ensure people received a quality service and a complaints procedure was in place in case people using the service were not satisfied with the treatment they received.