We carried out an announced comprehensive inspection on 28 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

Welldene dental practice provides general dentistry. The practice provides NHS and private services for patients in Ashford, Kent and the surrounding area.

The practice staff include three dentists, three dental nurses a dental hygienist and receptionists. Those are supported by a practice manager and an assistant practice manager. Dental services are provided Monday to Friday 8.30am to 5.30pm,

We talked to five patients. We looked at 73 comment card completed by patients specifically for this inspection. The patients said, and the comment cards supported this, that the practice offered an excellent service and staff were efficient, helpful and caring. They said that staff had time to spend with them, they said that it was easy to get appointments and that if they needed emergency treatment staff made time to fit this in. They said that staff took time to explain procedures to them and give advice on the prevention of dental problems. They said that staff treated patients with dignity and respect

The practice manager is also 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.

Our key findings were

• There were effective systems to reduce the risk and spread of infection. We found that all the treatment rooms and equipment appeared clean.
• There were systems to check all equipment had been serviced regularly including, autoclaves, fire extinguishers, oxygen cylinder and the X-ray equipment.
• Dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• The practice ensured staff maintained the necessary skills and competencies to support the needs of patients.
• The practice was aware of current guidelines.
• Patients were provided with information and were involved in decision making about the care and treatment they received. We observed staff to be kind, caring, and responsive to patient’s needs.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society
• The practice should review and check that all staff carry out decontamination following the agreed process.
• Check all audits, including radiographic audits, have learning points documented so that the resulting improvements can be demonstrated.
• Review at appropriate intervals the training, learning and development needs of individual staff members and have an effective process established for the appraisal of all staff.

Our last inspection in April 2013 identified some concerns that patients who used the service and others having access to premises were not protected against the risks associated with unsafe premises, by means of adequate maintenance of the cellar.

We carried out this follow up inspection to check that improvements had been made.

We found that the improvements required following our previous inspection had been fully completed and that patients who used the service and others having access to the premises were protected from the risks associated with unsafe premises. This was because building work had been completed to repair the ceilings and reposition the electrical wires. All dental materials that had been contaminated had been destroyed and materials were stored in a designated store room. All patient records were stored securely in a locked room and old records archived in secure boxes.

We were unable to speak with patients who used the service or observe any care or support given.

We spoke with four patients who told us that they were happy with the service provided. Patients told us they were very satisfied with the practice. They said they never had to wait long for appointments, and in an emergency they had always been seen on the same day. One person said “My wife and I have been coming here for years, we are very pleased. We are very pleased with it all, we would not change for anything”. Patients said their treatment plans were always explained and discussed with them, including choices about treatment and costs. Patients said that the clinic was always clean, and all the staff were friendly, welcoming and respectful.

We looked around the practice and saw that areas of the premises were not being appropriately maintained.