We carried out an announced comprehensive inspection on 09 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

Homewood Dental practice is located on the ground and first floor of a purpose adapted property in Brentwood, Essex and offers a range of private general preventative, restorative and cosmetic dental treatments to adult patients and children. The practice is part of the Dental Care Group.

The practice is open and offers appointments for patients between 8am and 6pm on Mondays to Fridays and by appointment only on Saturdays.

The practice employs nine associate dentists, three foundation level dentists, six qualified dental nurses and three trainee dental nurses. The dental team is supported by three receptionists and a practice manager.

The practice is registered with the Care Quality Commission (CQC) as an organisation. The practice has a registered manager. 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 practice has ten treatment rooms, a combined waiting room and a reception area. Decontamination takes place in a dedicated decontamination room (Decontamination is the process by which dirty and contaminated instruments are bought from the treatment room, washed, inspected, sterilised and sealed in pouches ready for use again).

Our key findings were:

• The practice had systems in place for sharing relevant information, investigating and learning from complaints, safety incidents and accidents. Staff were aware of their responsibilities to report incidents.
• The practice was visibly clean and clutter free. Infection control practices were reviewed and audited to test their effectiveness. However we found some dental instruments that were packaged incorrectly and some for which the sterilisation expiry date has passed.
• There were systems in place to help keep people safe, including safeguarding vulnerable children and adults.
• The practice had medicines and equipment for use in the event of a medical emergency were in line with current guidelines. Records were maintained in respect of the checks carried out for these medicines and equipment.
• The practice had arrangements for monitoring safety when taking X-rays. However we saw that the rectangular collimator had been removed from some of the X-ray machines. Collimation is a way by which the beam of radiation is narrowed so that it is focused on a specific area and so minimises exposure to radiation of surrounding tissues.
• Staff undertook training in respect of their roles and responsibilities within the practice.
• Patients reported that they were very satisfied with their treatment and that staff were respectful and helpful.
• Patients were provided with detailed information and treatment plans and were involved in making decisions about their care and treatments.
• The practice could normally arrange a routine appointment within a few days and appointments were flexible to meet the needs of patients.
• Effective governance arrangements were in place for the smooth running of the service.
• Audits and reviews were carried out to monitor and improve services,
• Patient’s views were sought and these were used to make improvements to the service where these were identified.

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

• Review the protocols and procedures for use of X-ray equipment giving due regard to guidance notes on the Safe use of X-ray Equipment. This relates to the use of a rectangular collimator.
• 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. This relates to checking that sterilised instruments are packaged correctly and checked for their expiry date.