We carried out an announced comprehensive inspection on 9 November 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

Heathfield Dental Clinic is a NHS dental practice in Croydon. The practice is situated in a converted residential property. The practice is set out over one floor and has 8 dental treatment rooms (although only five were in use at the time of our inspection and the other three had just been developed), three patient waiting rooms, one of which was at the reception, a separate decontamination room for cleaning, sterilising and packing dental instruments, a staff office, staff room and two patient toilets (one of which was disabled accessible).

The practice is open 9.00am to 8.00pm Monday to Fridays and 9.00am to 1.00pm Saturdays. They were also funded by the NHS to provide out of hours dental treatment from 6.30pm to 8.00pm Monday to Fridays and 10.00am to 1.00pm Saturday and Sundays. The practice has seven dentists, one dental nurse and seven trainee dental nurses.

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

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 10 patients via completed comment cards. Patients provided a positive view of the services the practice provides. They commented on the quality of care, the friendliness and professionalism of all staff, the cleanliness of the practice and the overall quality of customer care.

Our key findings were:

• Leadership was clear and roles and responsibilities well defined.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Infection control procedures were robust and audits were being completed periodically.
• The practice had a safeguarding lead with information available to staff to refer to. Staff demonstrated knowledge of safeguarding.
• The practice had a system in place for reporting incidents which the practice used for shared learning.
• Dentists provided dental care in accordance with current professional and National Institute for Health and Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff recruitment files included relevant pre recruitment documents such as CVs and references.
• There was a structured approach to learning and development. Staff had the opportunity to attend learning and training events.
• Staff we spoke with felt well supported by the practice owner and were committed to providing a quality service to their patients.
• Feedback from patients gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

We spoke with three patients. One patient told us, “Nothing but positive things to say about how they treat me, what they tell me and how much it will cost. Really, it’s a good place.” Another patient told us, “The staff and dentists make you feel very comfortable.” One patient said, “They say what they are doing, explain everything and make you feel comfortable.”

We saw that patients were involved in their treatment and provided consent before any treatment was started. We found that people were protected from the risks of abuse. We saw that there were effective systems in place to minimise the risk of infection. We also found that systems were in place to assess and monitor the quality of service provision.