We carried out an announced comprehensive inspection on 01 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

Orpington Dental Care practice is located in the London Borough of Bromley. The premises are laid out over the ground floor with a shop front on a high street location. There are four treatment rooms, a dedicated decontamination room, waiting room with reception area, staff room, and toilet.

The practice provides private dental services for adults and NHS and private services for children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and bridges, and oral hygiene.

The staff structure of the practice is comprised of a principal dentist (who is also the owner), three associate dentists, two hygienists, five dental nurses, and two receptionists. There was also an anaesthetist who was contracted to provide sedation services, when required.

The practice opening hours are from 8.00 am to 5.00pm on Monday, 8.00am to 7.00pm on Tuesday and Wednesday, 8.30am to 4.00pm on Thursday and 8.00am to 3.00pm on Friday.

The principal dentist is the registered manager. A registered manager is a person who is registered with the CQC 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.

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

Sixteen people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

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).

• There were effective systems 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 children living in vulnerable circumstances.

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

• Staff reported incidents and kept records of these which the practice used for shared learning.

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

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

• The principal dentist had a clear vision for the practice and staff told us they were well supported by the management team.

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

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

• Review and update the complaints policy to reflect changes in personnel and regulations, and put in place a system for identifying trends in complaints over time.

• Review and undertake additional risk assessments, and implement associated risk reduction protocols, in relation to the location of the air compressor and X-ray equipment (OPG), as well as for the safe use of sharp dental instruments.

• Review staff training to ensure that dental nursing staff who are assisting in conscious sedation have the appropriate training and skills to carry out the role giving due regard to guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care’ (2015).

• Review recruitment procedures to ensure that references for new members of staff are sought prior to the commencement of the employment contract.

People who used the service told us the dentists provided them with relevant information and different options to allow people to make informed decisions about their care and treatment. One person told us the information provided was ‘very thorough’. People told us information about costs was made clear to them before treatments.

People told us their privacy and dignity was maintained during treatments and consultations.

People told us the staff were friendly and polite. One person told us they were nervous about having treatment but staff listened to their concerns and put measures in place to help this person receive treatment more comfortably. Another person told us they had been seen in an emergency.

One person told us the surgery was a ‘very good place’ and they ‘wouldn’t go anywhere else’.

People told us they felt the surgery was clean and one person mentioned the dentist always wore gloves and a mask when treating people.