We carried out an announced comprehensive inspection on 6 January 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

Forest Hill Dental Practice is located in the London Borough of Lewisham and provides predominantly NHS dental services. The demographics of the practice were mixed, serving patients from a range of social and ethnic backgrounds.

The practice staffing consists of eight dentists, two dental nurses, nine trainee dental nurses, one receptionist and a practice manager. Some of the trainee dental nurses also performed reception duties.

The practice is open from 9.00am to 7.00pm on Monday to Fridays and from 9.00am to 1.00pm on Saturdays. The practice is located on the first floor of the building and facilities include six consultation rooms, a reception area, patient waiting room, decontamination room, staff room/administration office. The premises were not wheelchair accessible; however there were arrangements in place with other dental surgeries close by with wheelchair access if patients needed to be referred.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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 dentist specialist advisor.

We received 31 completed Care Quality Commission comment cards and spoke with seven patients during our inspection. Patient feedback was very positive about the service. Patients told us that staff were professional and caring and treated them with respect. They described the service as very good and providing an excellent standard of care. Information was given to patients appropriately and staff were helpful.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Appropriate systems were in place to safeguard patients from abuse
• The provider had emergency medicines and equipment such as oxygen and an automated external defibrillator in line with national guidance.
• All clinical staff were up to date with their continuing professional development.
• Patients’ needs were assessed and care was planned in line with current guidance.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• Governance arrangements were in place for the smooth running of the practice; and the practice had a structured plan in place to audit quality and safety which included the mandatory audits for infection control and radiography.

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

• Review the practice's recruitment policy and procedures to ensure up to date disclosure and barring services (DBS) checks are carried out prior to employment of staff.

We spoke with six patients during our inspection. They were all satisfied with the treatments they had received and made positive comments about the practice. Patients told us they were informed about the different treatment options available to them, and that they were involved in making the decisions about their treatments. One patient told us, "I've been the main decider (regarding the treatments I have had)." Another patient told us, "They explain all the treatment steps, and about the later appointments and what's going to happen."

There were arrangements in place to reduce the risk and spread of infection, including staff training, policies and procedures, and decontamination arrangements.

Staff were supported in their work and had access to continuing professional development (CPD). Subjects covered as part of staff CPD included a range of topics related to their professional work, such as infection control and medical emergencies. Patients spoke well of the staff in the practice, describing them as "very good", "polite and friendly", and "helpful".

Quality monitoring arrangements were in place in the service, including survey questionnaires and audits and incidents recording and management.