We carried out an announced comprehensive inspection on 1 December 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

Beach Road Dental Practice is located close to the centre of Hartford, in a converted residential property and comprises two treatment rooms, a dedicated decontamination room, waiting room, and storage and staff rooms, all on the ground floor. There are low steps leading into the practice, marked with white edges, and a handrail at the side of the steps. Parking is available on nearby streets.

The practice provides general dental treatment for adults and children, both NHS and private patients. The practice is open Monday to Thursday 8.30am-5.30pm and Friday 8.30am-3.00pm.

There are two dentists, one dental therapist/hygienist, two dental nurses, a trainee dental nurse, and a practice manager.

Dr Angela Simpkins is the registered provider. A registered provider is registered with the Care Quality Commission to manage the service. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

We received 29 completed patient comments cards and spoke to four patients during the inspection. All these patients were very positive about the care and treatment they received from the practice. Patients commented that the staff were caring, helpful and respectful. Staff listened to, and took account of, their individual needs. Patients reported no difficulty in arranging an appointment and treatment was carried out promptly in a safe and hygienic environment.

Our key findings were:

• Appropriate equipment was available for staff to undertake their duties, and equipment was well maintained. However the practice was unable to show the Health and Safety Executive had been notified of the use of X-ray equipment on the premises.
• The practice recorded and analysed incidents and complaints and cascaded learning to staff. However information was not available about the next steps should a complainant be unsatisfied with the practice’s response.
• Most staff had received safeguarding training, demonstrated good awareness and knowledge and knew the processes to follow to raise concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.
• There were effective systems in place to reduce and minimise the risks and spread of infection. However cleaning equipment, (mops), were not properly stored.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current practice and legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about treatment.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice had a clear leadership structure, and staff felt involved and worked as a team.
• The practice sought feedback from staff and patients about the services they provided.

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

• Review staff training in relation to safeguarding in accordance with current practice.
• Review the practice’s infection control procedures and protocols having due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review the practice’s complaints procedure and provide information in relation to escalating complaints.
• Establish whether the practice is in compliance with its legal obligations under the Ionising Radiation Regulations (IRR) 1999.
• Implement a scheduled maintenance plan to bring the internal environment up to a standard that would support infection prevention and control.

We spoke to a sample of patients who were visiting the practice during our visit.

Patients told us they were given various information about their treatment and knew what to expect. Two of the people we spoke to had been at the practice for many years. They explained that they felt the level of service was; “very good”. One person told us that all their family came to the practice. Everyone stated they were always consulted and they gave full consent about their treatment and check ups. Most people were aware of their costs and treatments.

The patients we spoke to had been with the practice for many years and told us that the care they experienced was “good” and that they had no problems. Everyone told us they were happy with the level of service and care offered.

We asked about the practices complaints procedures and one patient told us that if they had any concerns they would not have any hesitation in raising them with the staff directly.