We carried out an announced comprehensive inspection on 25 November 2015 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

Leagrave Dental Sedation Clinic has seven dentists and a medically qualified sedationist. There are also nine qualified dental nurses registered with the General Dental Council (GDC) and two dental nurses in training.

Leagrave Dental Sedation Clinic provides a mix of NHS and private dental treatment including conscious sedation, minor oral surgery and the placement of dental implants. The practice has a contract to provide conscious sedation and minor oral surgery services with NHS England and currently provides 2500 episodes of conscious sedation annually.

The premises are housed in a converted and extended domestic property and consist of four general dental treatment rooms and a well-equipped sedation suite where conscious sedation is provided by a medically qualified sedationist. There is a separate decontamination room for sterilising dental instruments, a room housing a specialised X-ray machine and CT scanner. There is also a reception area and waiting rooms on each floor. Two of the dental treatment rooms and the sedation suite were on the ground floor enabling disabled access.

The clinical lead is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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. Supporting the Registered Manager is a practice manager, deputy manager, a senior administration assistant and clinical governance lead, a receptionist administrator and receptionist. The company has a Managing Director and a Clinical Director.

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 collected 15 completed cards. These provided a very positive view of the services the practice provides. All of the patients commented that the quality of care was very good.

We carried out an announced comprehensive inspection on 25 November 2015 as part of our planned inspection of all dental practices. The inspection was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• We received feedback from 15 patients which was all very positive. Common themes were patients felt they received excellent service from kind and caring staff in a welcoming environment.
• We observed staff to be very friendly and empathetic to the needs of patients.
• Staff had been trained to handle emergencies and appropriate medicines and equipment to deal with medical emergencies was available in accordance with current guidelines.
• Conscious sedation was delivered safely in accordance with current guidelines.
• Infection control procedures were robust and the practice followed published guidance. The practice was visibly clean and well maintained.
• All equipment used in the practice was well maintained in accordance with the manufacturer’s instructions.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff demonstrated knowledge of the practice’s whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.
• Patients’ needs were assessed and care was planned and delivered in line with current professional guidelines.
• The practice placed an emphasis on the promotion of good oral health and provided regular oral health instruction to patients.
• The practice had enough skilled and competent staff to deliver the service safely and effectively.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).
• The practice took into account any comments, concerns or complaints and used these to help them improve the practice.
• There were effective systems in place to assess, monitor and improve the quality of service provided. The practice is a member of the British Dental Association (BDA) Good Practice scheme. This is a quality assurance programme that allows its members to communicate to patients an ongoing commitment to working to standards of good practice on professional and legal responsibilities.
• There were effective systems in place to assess, monitor and mitigate risks to patients, staff and visitors to the practice.