We carried out an announced comprehensive inspection on 19 May 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

Green Street Green Dental Practice is located in the London Borough of Bromley. The premises are situated in a parade of shops in a high street location. There are two treatment rooms, a reception area and a patient toilet on the ground floor.

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 practice also offers a full range of treatments including implants and Specialist root canal treatment and Specialist periodontal treatment.

The staff structure of the practice consists of a principal dentist, who specialises in prosthodontics, an associate periodontist, an associate endodontist, an associate dentist, four hygienists, three dental nurses, a newly appointed practice manager, a finance administrator and three receptionists.

The practice opening hours are on Monday, Tuesday, Thursday and Friday from 8.00am to 6.00pm, Wednesday from 8.00am to 8.00pm, and Saturday from 8.00am to 2.00pm.

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.

Fifty-one 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.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• There was a policy in place for the recording and investigating of incidents. However, we found that this had not always been effectively followed by all staff to support shared learning.
• There were arrangements in place for managing medical emergencies. However, some of the equipment needed for responding to medical emergencies needing renewing or replacing 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.
• 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.
• 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 the system for recording and investigating incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review 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 current Legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, 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 sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

The people we spoke with during our visit on 9 February 2012 told us that they were very pleased with the dental service they received. They told us they had discussed and agreed their treatment plans with their dentist.

We observed people being greeted by name, and treated courteously and respectfully. Dentists and practice staff were friendly and approachable.

Responses to a patient satisfaction survey showed that people rated highly all aspects of the service. The survey looked at, amongst other things, the ease of accessing dental care, the staff’s willingness to help, and the neatness and cleanliness of the practice.