Old Court House Dental Practice

Updated 20 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the practice was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We carried out an announced, comprehensive inspection on 14 March 2016. The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

We reviewed information received from the provider prior to the inspection. During our inspection we reviewed policy documents and spoke with five members of staff. We conducted a tour of the practice and looked at the storage arrangements for emergency medicines and equipment. One of the dental nurses demonstrated how they carried out decontamination procedures of dental instruments.

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. 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.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 20 April 2016

We carried out an announced comprehensive inspection on 14 March 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

Old Court House Dental Practice is located in Dorking, Surrey. The premises are situated at the beginning of the High Street and has a private staff car park at the back. There are three levels to the premises including a basement level leading to the car park. The basement level has a treatment room, a decontamination room, an office and two patient toilets for male and female. The next level is the ground level and consists of a second treatment room, reception and waiting area and the main entrance to the practice. The upper level has a third treatment room, an X-ray room and a staff room.

The practice provides private services to adults and children. There is as a limited NHS service for children that are already registered with the practice. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges. Visiting dentists provide specialist periodontal treatment, implant services and root canal treatment.

The practice staffing consisted of two principal dentists (who were also the owners), three visiting dentists providing specialist dental services, two hygienists, three dental nurses, one receptionist and one practice manager. The dental team worked various part-time hours depending on the need.

The practice opening hours are Monday and Tuesday from 8.00am to 5.30pm, Wednesday from 8:00am to 7:00pm, Thursday from 9:00am to 5:00pm, Friday 8:00am to 4:00pm and Saturday from 9.00am to 1.00pm by arrangement only.

One of the principal dentists 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 CQC inspector and a dental specialist advisor.

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. 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).

• The practice had an ongoing programme of risk assessments and audits which were used to drive improvement.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes 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 child protection
• 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.

• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• All clinical staff were up to date with their continuing professional development.
• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

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

• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff.