We carried out an announced comprehensive inspection on 22 September 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

Aldridge Dental Practice is a dental practice providing general dental services on a NHS and private basis. The service is provided by five dentists. They are supported by five dental nurses (three of whom are trainees), a practice manager and two receptionists. A sixth dentist visits the practice on a monthly basis to provide dental implants and other oral surgery procedures.

The practice is located on a main road near local amenities and bus routes. There is wheelchair access to the practice and car parking facilities. The premises consist of a waiting room, a reception area, an office, four treatment rooms, two decontamination rooms, a staff room, an X-ray room, storage rooms and toilet facilities for patients with disabilities. Opening hours are from 8am to 8pm every Wednesday and from 8:30am to 5:30pm on all other weekdays.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (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.

Fourteen patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with three patients. The information from patients was generally complimentary. Patients were positive about their experience and they commented that staff were friendly and caring.

Our key findings were:

• The practice was organised and appeared clean and tidy on the day of our visit. Many patients also commented that this was their experience.
• Patients told us they found the staff polite and friendly.
• An infection prevention and control policy was in place. We saw the decontamination procedures followed recommended guidance.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Staff received training appropriate to their roles.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with. Documentation of complaints required improvements.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• Practice meetings were used for shared learning.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping; however, the infection control audits were not being carried out every six months as per guidance.
• The practice had systems to assess and manage risks to patients, including health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. Some of these required improvements.
• Patients were able to make routine and emergency appointments when needed; however, some patients commented they had to wait lengthy periods before getting an appointment at their preferred time.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as Public Health England (PHE).

• Review availability of medicines and equipment 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. These should extend to domiciliary visits too. The practice should review stocks of medicines and equipment and the system for identifying and disposing of expired stock.

• Review the practice’s audit protocols of various aspects of the service such as infection control at regular intervals to help improve the quality of service.
• Review the practice’s procedures for documenting safeguarding incidents and complaints to ensure that all are recorded in sufficient detail.

We saw records to demonstrate that before people agreed to any treatment, the various options available to them were discussed. People told us that they had all of the information that they needed to be able to make a decision.

Patient records were in good order and up to date. Information regarding medical history was kept under constant review. Dental health and hygiene information was given to people when they visited the dental practice. One person spoken with told us, "Since I have been going to this dentist I have never taken so much care of my teeth, they tell you exactly how to look after your teeth, I can’t praise them enough."

We saw that the dental practice looked clean and clutter free. Records demonstrated that all areas of the practice were cleaned in line with procedures. Training records demonstrated that staff received regular training regarding infection control and decontamination procedures. People we spoke with said that the dental practice was always clean.

We saw annual staff appraisal records, we were told that weekly dental team talk meetings took place and staff meetings were also held every six to eight weeks. From records seen and discussions with the practice manager it appeared that staff received the necessary support to enable them to do their job.

Quality assurance systems included satisfaction surveys,a suggestions box and various audits undertaken by the practice manager. Robust quality assurance systems were in place.