We carried out an unannounced comprehensive inspection on 20 January 2016 due to information of concern we received with regard to infection control. 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 Jasvinder Kaila’s Dental Practice provides predominately NHS dental services with private treatment options available for patients. The premises consist of a waiting area, three treatment rooms, staff area and a reception area. The practice does not have a separate decontamination room and decontamination and sterilisation are carried out in the treatment rooms by temporal separation method.

The staff at the practice consist of the practice owner (principal dentist), an associate dentist, a foundation trainee dentist, two dental nurse’s, a student nurse, two receptionists and a practice manager/ head dental nurse.

The principal dentist 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.

We did not review or supply any Care Quality Commission (CQC) comment cards for patients as this inspection was unannounced. We did review feedback from patients who had completed the ‘Friends and Family Test’ and spoke to nine patients following our inspection and found that the feedback was positive.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, however equipment had not been maintained regularly as per guidance and legislation.
• Patients care and treatment was planned and delivered in line with current legislation and evidence based guidelines such as from the National Institute for Health and Care Excellence (NICE)
• Patients were treated with dignity and respect and confidentiality was maintained at all times
• The practice had a procedure for responding and acting on complaints
• The appointment system met the needs of the patients and where possible waiting times were kept to a minimum
• The practice had effective systems to reduce the risk of the spread of infections

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result
• Review stocks of medicines and materials and implement a system for identifying and disposing of out-of-date stock.
• 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.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the 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.
• Implement a system to monitor staff training which links into appraisals.
• Update all practice policies and procedures to reflect current legislation and guidance and put into place a system for updating all governance documentation
• Review the current fire safety processes at the practice and complete training in fire safety and awareness.

The provider was meeting this standard. People were cared for, or supported by, suitably qualified, skilled and experience staff.

We spoke with six people who used this service and they all told us that staff were welcoming and helpful. We saw that patients were greeted courteously and treated with respect by the staff.

Everyone we spoke to gave positive feedback about this service and one told us, “The operation is excellent. They do discuss treatment with you and I have complete trust in them”. We saw from the four written treatment notes we examined that medical histories were updated during every consultation. A written treatment plan had been prepared for one patient.

Four of the people we spoke with commented on the cleanliness of the practice. One said, “The whole place is of an acceptable standard and the surgery is scrupulously clean.” We saw that the premises were clean and well maintained.

We found staff to be to be knowledgeable and to have received current training appropriate to their roles. A suitable complaints procedure was in place and we saw that staff were approachable and responsive.