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Archived: D A & C Houston & Associates - Milton Road

The provider of this service changed - see new profile

Inspection Summary

Overall summary & rating

Updated 27 August 2015

We carried out a comprehensive inspection of D A & C Houston & Associates - Milton Road on 9 January 2015.

The group of practices are comprised of four separate treatment centres, all conveniently located on the same site. All four buildings have been adapted and are compliant with the Disability Discrimination Act (DDA) 1995. They have a total of 26 treatment rooms; four of these are specifically for hygienist treatments. D A & C Houston & Associates - Milton Road has 23 dentists, of which two are the principal dentists and partners (provider); three visiting specialists who attend the practice regularly; six dental hygienists and a large number of dental nurses and reception staff.

There is a dedicated Local Decontamination Unit (LDU) in each building. The practice provides both NHS and private dental treatment to adults and children.

The practice offers conscious sedation for nervous patients and is a training practice for a foundation dentist. A foundation dentist is someone who has completed the academic part of their training and is completing their practical training and consolidating their learning under the mentorship of an experienced dentist.

The partner dentists are legally responsible for making sure the practice meets CQC requirements as is the registered manager.

We found the practice staff were friendly, welcoming and informative. The provider has created an atmosphere where excellence is promoted. We saw evidence of good communication and team work.

We spoke with five patients who used the service on the day of our inspection and reviewed 22 CQC comment cards that had been completed by patients prior to the inspection. The patients we spoke with were very complimentary about the service. They told us they found the staff to be extremely person-centred and felt they were treated with respect. The comments on the CQC comment cards were also very complimentary about the staff and the service provided. We were also shown feedback from other professionals who work with the practice and they reported the practice was patient centred and sought to provide dental treatment in line with the latest guidance.

During the inspection we toured the premises and spoke with a majority of staff on duty that day. This included the principle dentist. To assess the quality of care provided by the practice, we looked at practice policies and protocols and other records. Our key findings were as follows:

  • The practice provided safe, effective and caring treatment which met patients’ needs.

  • There were systems in place for staff to report incidents. There were sufficient staff on duty to deliver the service. There was enough equipment available for staff to undertake their duties and we saw the premises were in a satisfactory state of repair. It was clean and tidy.

  • Patient’s needs were assessed and care was planned and delivered in line with current best practice guidance. This included the promotion of good oral health. We saw evidence staff had received training appropriate to their roles and further training needs were identified and planned through an effective appraisal system.

  • The patients we spoke with and all comment cards we reviewed indicated patients were consistently treated with kindness and respect by staff. It was reported that communication with patients and their families, and access to the service and to the dentists was good. Patients reported good access to the practice with emergency appointments available the same day.

  • The practice had procedures in place to take into account any comments, concerns or complaints that were made to improve the practice.

  • The practice had two accessible and visible principle dentists and staff on duty told us they felt supported by the principles. Staff reported patients were at the heart of the practice. This included the promotion of good oral health. Staff had received training appropriate to their roles and there was an effective appraisal system in place.

What people who use the service say.

We spoke with five patients visiting the practice. The patients were a mixture of newly registered patients; patients who had been at the practice for a number of years and those who had been referred for specialist treatment offered in the practice. Those who were not newly registered had used the dental services between two and ten years.

The majority of comments made by patients were positive and praised the practice staff. For example they spoke about: receiving excellent care and treatment; the efficiency of the service (one person told us another had been able to get an emergency appointment on the same day) and about the caring attitude of dentists.

We heard and observed how some patients found access to the practice and appointments easy and how telephones were answered after a short period of waiting.

Patients told us their privacy and dignity was always respected during consultations and they found the reception area was generally private enough for most discussions they needed to make.

Patients spoken with told us the practice was always kept clean and tidy and the practice felt fresh, modern and spacious. Patients told us they liked the waiting areas as they did not feel cramped.

Inspection areas


No action required

Updated 27 August 2015

We found the practice was safe because it had effective systems in place in the areas of infection control, clinical waste management; management of medical emergencies in the dental chair and dental radiograph. Staff demonstrated awareness of their responsibilities to raise concerns and report incidents and accidents.

There were regular practice meetings that had items on the agenda regarding safety which demonstrated the practice was committed to providing a safe service for its patient population. All information about safety was recorded, monitored, appropriately reviewed and addressed. Staff had received safeguarding training and the practice assessed risks to patients and managed these well. The evidence demonstrated a safe service with patients being protected from abuse and avoidable harm.


No action required

Updated 27 August 2015

The practice carried out effective consultations in line with current National Institute for Health and Care Excellence (NICE) guidance. Patients were provided with advice to help them maintain healthy teeth and prevent tooth decay. The dental care provided was effective, evidence based and focussed on the needs of the patients. We saw examples of very good collaborative team working.

The staff were up-to-date and received professional development appropriate to their role and learning needs. Staff who were registered with the General Dental Council (GDC) had frequent continuing professional development (CPD) and were meeting the requirements of their professional registration. The evidence demonstrated care and treatment achieves good outcomes, promotes a good quality of life and is evidence-based where possible.


No action required

Updated 27 August 2015

The practice was a caring service. Patients were treated with dignity and respect and their privacy was maintained. Explanations about care and treatment were clear and followed up with a written treatment plan. Staff were aware of the need to maintain patient confidentiality. Patients felt involved in decisions about their care and treatment.

The latest patient survey reflected patients were satisfied with the staff and the services provided at the practice. We found the service to be caring from interviewing staff and patients and from observing the patient journey from reception through to completion of treatment. This evidence demonstrated clinicians listened to patients, and provided the appropriate treatment in a caring and patient centred manner.


No action required

Updated 27 August 2015

The service was responsive to needs of the local population by providing friendly family orientated dental care. NHS and private dental treatment was available at the practice and it met patients’ needs. The appointments system was effective and patients were satisfied with it. Patients could obtain emergency appointments on the same day as the practice offered dedicated emergency slots enabling effective and efficient treatment of patients with dental pain.

The practice was accessible for patients with a disability or mobility limitations. Comments and complaints were dealt with effectively and where ideas for improvement had been identified these were actioned. The practice responded to patient views from the practice survey.


No action required

Updated 27 August 2015

The dental practice was well-led with robust clinical governance and risk management structures in place. The practice has a very experienced practice manager and two principal dentists who worked to ensure best practice service provision. The practice provided clear leadership and services offered were monitored to identify areas for improvement.

Staff were aware of their roles and responsibilities and how they impacted on the overall vision of the practice. Staff were aware of the way forward and vision for the practice. They felt well supported and could raise any concerns with the practice manager. All staff told us it was a good place to work. Training and development was available and performance monitored. Regular clinical and non-clinical audits took place.

Patients were encouraged to provide feedback through a patient survey and by completing comment cards available at reception and could be placed in a confidential box. The evidence gathered showed the leadership, management and governance of the organisation assures the delivery of person-centred care, supports learning and innovation and promotes an open and fair culture.