We carried out a focused inspection of King’s Green Dental Surgery on 20 March 2018

The inspection was led by a CQC inspector.

We carried out the inspection to follow up concerns we originally identified during a comprehensive inspection at this practice on 4 May 2017 and 11 September 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement were required.

At the previous comprehensive inspections we found the registered provider was providing safe, effective, caring and responsive care in accordance with relevant regulations. We judged the practice was not providing well-led care in accordance with Regulation 17 HSCA (RA) Regulations 2014 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good Governance. You can read our reports of these inspections by selecting the 'all reports' link for King’s Green Dental Surgery on our website www.cqc.org.uk.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made sufficient improvements and had addressed the regulatory breaches we identified at our inspection on 4 May 2017 and 11 September 2017

We carried out a focused inspection of King’s Green Dental Surgery on 11 September 2017.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We carried out the inspection to follow up concerns we originally identified during a comprehensive inspection at this practice on 4 May 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

At a comprehensive inspection we always ask the following five questions to get to the heart of patients’ experiences of care and treatment:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement were required.

At the previous comprehensive inspection we found the registered provider was providing safe, effective, caring and responsive care in accordance with relevant regulations. We judged the practice was not providing well-led care in accordance with Regulation 17 HSCA (RA) Regulations 2014 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good Governance. You can read our report of that inspection by selecting the 'all reports' link for King’s Green Dental Surgery on our website www.cqc.org.uk.

Our findings were:

Are services well-led?

We found this practice was not providing well-led care in accordance with the relevant regulations.

The provider had made insufficient improvements to put right the shortfalls and had not dealt with the regulatory breaches we found at our inspection on 4 May 2017.

We carried out this announced inspection on 04 May 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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 not providing well-led care in accordance with the relevant regulations.

When we inspected the service on 21 May 2013 we found that the decontamination room did not meet the standards expected. We also found that the infection control lead and the provider were unable to provide details of any actions taken to address shortfalls identified during the annual audit undertaken in line with The Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

We carried out a further inspection of the service on 22 August 2013. We found that the provider had addressed all the areas that we had identified as falling short of the expected standards within the decontamination room. We also saw evidence of actions taken to address shortfalls identified during the audits undertaken in line with The Health Technical Memorandum 01-05: Decontamination in primary care dental practices in August 2012 and on 30 May 2013.

People who used the service understood the care and treatment choices available to them. People told us they were satisfied with the care and treatment they received, one person said, “All the information about my treatment and the costs were shared with me, there were no hidden surprises.”

We saw feedback from people who used the service obtained via a quality assurance questionnaire. The person had commented, “I have been very happy with the service provided. I trust the dentist to only do work which is necessary and to be very cost conscious.”

We saw that the environment was generally well maintained and clean however, we found some shortfalls in infection control practices. Audits were not available to show that regular monitoring took place to ensure the premises were clean or that the infection control processes were robust.

People who used the service told us that the staff team were kind, friendly, courteous and welcoming.

We saw that the complaints policy gave timescales for responses and actions so that people knew what to expect. It told them how to take their complaint further should they not be satisfied with the provider’s response.