We carried out an announced comprehensive inspection on 29 July 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

B J Julius Dental Practice is situated in the Rossington area of Doncaster, South Yorkshire. It offers mainly NHS treatment to patients of all ages but also offers private dental treatments. The services include preventative advice and treatment, routine restorative dental care and orthodontics.

The practice has four surgeries, a decontamination room, a waiting area and a reception area. The reception area, waiting area and one surgery are on the ground floor. The other three surgeries and the X-ray room are on the first floor. There are accessible toilet facilities on the ground floor of the premises.

There are five dentists (including one orthodontist), a dental hygienist, five dental nurses, a decontamination assistant, a receptionist (who is also a qualified dental nurse) and a practice manager . They also employ a domestic.

The opening hours are Monday to Friday from 9-00am to 5-00pm.

The principal dentist 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.

During the inspection we spoke with eight patients who used the service and reviewed 50 completed CQC comment cards. The patients were all positive about the care and treatment they received at the practice. Comments included that the staff were polite, friendly and professional and the surgery was clean and in excellent condition. They also commented that were involved in decisions about treatment and it was well explained.

Our key findings were:

• The practice appeared clean and hygienic.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed that patients were treated with kindness and respect by staff.
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• Patients were able to make routine and emergency appointments when needed.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and the Health and Safety Executive –Approved Code of Practice L8: Legionnaires’ disease. The control of legionella bacteria in water systems.
• Review the practice’s process for the validation of the autoclaves giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• Review the practice’s audit protocols for infection control giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

People who used the service understood the care and treatment choices available to them. During this inspection we spoke with three people who used the service. One person said "the staff here are really good."

People’s needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. Those people we spoke with told us they were happy with the treatment that they received. One person said, "my dentist is fantastic with me and my family."

There were effective systems in place to reduce the risk and spread of infection. We saw that surgeries were clean and well maintained. Staff told us and we saw that specific cleaning routines were in place to maintain hygiene standards.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. Everyone we spoke with told us how questionnaires were used to gain people’s views. We saw the analysis of this feedback. Very positive feedback had been recorded.