We carried out an announced comprehensive inspection on 5 October 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

Mr Arvind Jain’s practice (also known as Hounslow West Surgery) provides NHS dental services to adults and children and also offers private treatments. Dental services include oral health promotion, routine examinations and treatment, bridges and veneers.

The practice is located on the first floor of the building and is accessible by stairs. The surgery has two treatment rooms, a reception area with seating and an accessible toilet. The practice is staffed by one principal dentist, (who is the owner), two practice nurses and reception staff. At the time of the inspection, a vocational equivalent trainee dentist was also working at the practice.

The practice is open Monday to Friday between 8.00am and 6.00pm and Saturday morning.

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 team of two CQC inspectors and a dentist specialist advisor. Eleven patients provided feedback about the service.

Patients we spoke with, and those who completed comment cards, were positive about the care they received from the practice. Patients described the service as good and the staff as friendly. They said they were kept informed, including about the costs, and involved in decisions about their care.

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).

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

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• Patients indicated that they felt they were listened to and that they received good care from a helpful and patient practice team.

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

• The principal dentist was a visible leader and staff told us they were well supported by the dentist and their colleagues.

• Governance arrangements were effective in improving the quality and safety of the services.

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

• 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.
• Review the practices’ current Legionella risk assessment and implement the required actions including regularly monitoring and recording water temperatures 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.
• Review availability of an interpreter services available to patients who do not speak English as a first language.

• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff. Review practice’s recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Install privacy film (or some other method of screening or blind) to the internal window in the treatment room to protect patient privacy.

Patients told us that they were very happy with the treatment and general level of service they received from the practice. They said that the dentist explained their treatment options clearly to them and gave them time to ask any questions they had about their treatment. They said they were given clear information about the cost of their treatment.

Patients said that their privacy was always respected during treatment and that they could always discuss their treatment with the dentist in private. They said that the dentist, dental nurses and reception staff were always polite and professional.

Patients told us they were happy with the practice’s appointment system and that they could get an appointment quickly at a time that suited them. They said they were seen on time for their appointments. Patients told us that the practice responded very well if they needed treatment urgently.