We carried out an announced comprehensive inspection on 16 December 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

First Dental Grove Park is located in the London Borough of Lewisham. The premises are situated in a converted residential building. There are two treatment rooms, a decontamination room, a waiting room, and patient toilets on the ground floor. There are administrative offices and a staff kitchen on the first floor of the building.

The practice provides NHS and 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, an associate dentist, two dental nurses, who also act as receptionists, and two trainee dental nurses.

The practice opening hours are Monday to Friday from 9.00am to 5.30pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

Thirty 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).

• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.

• Staff reported incidents and kept records of these which the practice used for shared learning.

• There were effective arrangements in place for managing medical emergencies. However, additional child-sized equipment needed to be purchased at the time of the inspection.

• 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, systems for managing stock and security of prescription pads could be improved.

• 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.

• There were effective systems in place to reduce and minimise the risk and spread of infection. However, we noted that some improvements to cleaning protocols could be made.

• 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. Improvements could be made to auditing systems to further improve the quality of the service.

Our key findings were:

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

• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.
• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s infection control procedures and protocols taking into account 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 protocols for completion of dental records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records to help improve the quality of service.

People we spoke with were happy with the service and treatment they received. One person told us, “The service is excellent. I give them five out of five.”

People were asked for their consent before any treatment began. Information leaflets and resources were used to discuss treatment options so people were aware of what the treatment involved and were able to give informed consent.

People had individual treatment plans in place. There were processes in place to deal with medical emergencies.

The practice was kept clean and there were effective systems in place for the decontamination of dental instruments.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

There was a complaints process in place which was displayed in the waiting area.