We carried out an announced comprehensive inspection on 21 December 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

Park House Practice in Southend provides private dental treatment to patients of all ages.

Practice staffing consists of two principal dentists, one of whom is the registered manager, one associate dentist, three hygienists, four dental nurses, a decontamination nurse, two receptionists and a practice manager.

One of the principal dentists 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.

The practice is open Monday and Tuesday 8am to 5.30pm, Wednesday and Thursday 8am to 4.30pm and Friday 8am to 2pm

The practice facilities include five treatment rooms, a reception area and two patients waiting areas, a decontamination room, two offices and a staff room/kitchen.

Six patients provided feedback about the service. Patients who completed comment cards were very positive about the care they received from the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• Equipment, such as the autoclaves, fire extinguishers, 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.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• 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).
• The practice sought feedback from patients about the services they provided and acted on this to improve its services.

• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.

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

• Review availability of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.

We spoke with one person who was using the service at the time of our inspection. They said they were happy with the practice. They said they could get appointments very quickly and that they saw the same dentist, which they liked. They said that they were involved in decisions about their care, given clear information about the treatment options available to them and gave consent accordingly. All treatment prices were fully explained. They said that the dentist checked their medical history at each visit. They said they would recommend the practice to others.

We also looked at the latest patient satisfaction survey results, which revealed a high satisfaction rate amongst respondents.

We found that the surgery was very clean but there was a lack of recording or checks taking place on the decontamination cycles and general cleaning that meant the provider had a lack of assurance. We also found that some patients’ dental records did not contain enough information to demonstrate that consent had been obtained or that treatments met those patients’ individual needs.