We carried out an announced comprehensive inspection on 11 February 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

Our findings were:

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.

Background

Farleigh Dental is located in the London Borough of Croydon. The premises are situated on the ground floor of a converted residential building. There are three treatment rooms, a decontamination room, reception area, waiting room, staff room and patient toilets.

The practice provides private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers, and crowns and bridges.

The staff structure of the practice consists of a principal dentist, two associate dentists, four hygienists and four dental nurses, some of whom also work as receptionists.

The practice opening hours are from Monday to Wednesday from 9.00am to 6.00pm, Thursday from 8.00am to 5.00pm, and Friday from 9.00am to 6.00pm.

The principal dentist is the registered manager. A registered manager is a person who is registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Forty-eight people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• There were effective systems in place to reduce and minimise the risk and spread of infection. However, some improvements in adherence to written protocols could be made.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff knew how to report incidents and how to record details of these so that the practice could use this information for shared learning.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced. However, we found that the ultrasonic bath had not received an annual service.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients. However, not all of the clinical staff had received a review which systematically identified their training needs.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

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

• Review recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review the practice’s infection control procedures and protocols 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 availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013
• Review the practice's protocols for completion of dental care records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review at appropriate intervals the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.