We carried out an announced comprehensive inspection on 25 February 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

Mill Hill Dental Health Centre is located in the Borough of Barnet and provides private dental treatment to adults. The premises are on the ground floor and consists of two treatment rooms, a consultation room, a reception area and a dedicated decontamination room. The practice is open Monday and Wednesday 9:00am – 5:30pm and Friday 9:00am – 1:30pm.

The staff consists of one dentist and two dental nurses. 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.

We reviewed six CQC comment cards completed by patients in the two weeks prior to our inspection and the practice patient satisfaction surveys. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.

• 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).

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• Patients were involved in their care and treatment planning so they could make informed decisions.

• There were effective processes 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 child protection.

• Equipment, such as the air compressor, autoclave (steriliser) and X-ray equipment had all been checked for effectiveness and had been regularly serviced.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The practice had implemented clear procedures for managing comments, concerns or complaints.

• Patients indicated that they found the team to be efficient, professional, caring and reassuring.

• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice had not carried out a sharps risk assessment.

• Improvements could be made to ensure the practice had an effective system in place to identify and dispose of out-of-date stock.

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

• Review recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff.

• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.

• Review its audit protocols to ensure audits of various aspects of the service, such as radiography and dental care records are undertaken at regular intervals to help improve the quality of service. Practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

Patients’ dignity was respected. The practice specialised in treating nervous patient using sedation (by injection or inhalation). The dentist told us that when patients arrived, time was initially spent offering reassurance about their treatment and answering any final questions.

Patients we spoke with were positive about the quality of care and treatment received. One patient referred to the practice as providing “very good care” whilst another patient told us that they were “happy with the way in which care was delivered.”

The dentist outlined the range of safeguarding measures used to protect staff and patients during sedation. These included a requirement that the patient be accompanied by a relative or friend during sedation.

We saw that the waiting area, treatment room and consultation room were clean and clutter free. None of the patients we spoke with expressed concerns about cleanliness or the overall environment. One patient remarked that the practice was “always very clean.”

The provider stored records required to protect the safety and wellbeing of patients. Patient notes showed that medical history questionnaires were updated at each visit, as necessary.