We carried out an announced comprehensive inspection on 10 February 2017 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

The Jevington Dental Practice 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, two offices and patient toilets on the ground and first floors 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, two associate dentists, a dental therapist, a hygienist, two dental nurses, a trainee dental nurse, and two receptionists.

The practice opening hours are on Mondays, Tuesday and Thursdays from 9.00am to 7.00pm, from 9.00am to 6.00pm on Wednesdays, from 8.00am to 5.00pm on Fridays, and from 9.00am to 1.00pm on Saturdays.

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.

Forty-nine 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.
• 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, some additional child-sized equipment and additional stock of emergency medicines 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.
• 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 availability of medicines and 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 storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.

We spoke with seven patients who all gave positive feedback about the care and treatment they had received. We observed the dentist and staff speaking to patients politely both at the practice and over the telephone and found they were happy to answer questions. We observed that records relating to patients were kept securely ensuring confidentiality. Patients told us that they were given time to think before undergoing treatment.

We found that people's oral health needs were assessed and treatment was planned and delivered in line with their individual treatment plan. People's care and treatment reflected relevant research and guidance.

The prevention and control of infection and decontamination of instruments was effectively carried out in accordance with guidance from the Department of Health. Patients we spoke with were positive about the cleanliness of the practice telling us "I was surprised that the facilities are very clean compared to my doctor and hospital services I have been to.”

We found that staff were well supported in their professional development and encouraged to take part in additional training. Staff received effective supervision, training and appraisal. We found there effective systems in place to regularly assess and monitor the quality of service in order to identify and manage risks.