We carried out an announced comprehensive inspection on 26 April 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

Bedale Dental Practice Limited is situated in Bedale, North Yorkshire. It offers NHS treatment for children and treatment for adults is provided either through a private dental plan or on a private basis. The services include preventative advice and treatment, routine restorative dental care, orthodontics and dental implants.

The practice has four surgeries, a decontamination suite, a waiting area and a reception area. All facilities are on the ground floor of the premises. There were accessible toilet facilities available.

There are four dentists (three partners and an associate), two dental hygienists, a clinical lead, eight dental nurses (one of which is a trainee), a reception manager, a receptionist and a practice manager. The practice also employs an external cleaner.

The opening hours are Monday from 9-00am to 6-00pm, Tuesday from 8-30am to 5-00pm, Wednesday from 9-00am to 5-00pm, Thursday from 8-30am to 6-00pm, Friday from 8-00am to 1-00pm and Saturdays (by appointment only) from 9-00am to 12-00pm.

One of the principal dentists is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

On the day of inspection we received 18 CQC comment cards providing feedback and spoke with five patients. The patients who provided feedback were positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and were very pleased with the service. They found the staff to be caring, respectful, helpful and relaxing and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention, control and health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Dental care records were detailed and showed that treatment was planned in line with current best practice guidelines.
• 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.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Patients were able to make routine and emergency appointments when needed.

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

• Review staff awareness of what a significant event is.
• Review the practice’s procedure for the checking of the Automated External Defibrillator (AED) on a weekly basis.
• Review the practice’s safeguarding policy ensuring the relevant contact details are clear.
• Review the practice’s procedure for the storage of local anaesthetics.
• Review the practice’s complaints policy to ensure it contains the time scales of when a complaint will be acknowledged and a formal response will be made.

During this visit we spoke with two dentists, two dental nurses and the practice manager. We also spoke with three people who had used the service during our visit.

People told us that they had always been consulted about their treatment options and had been given information to help them make decisions about their treatment. Treatment records showed that people’s treatment was appropriately planned and recorded, with people agreeing to their treatment before it was provided. Comments made to us by people who used the service included ‘before he starts work you know what he’s going to do, including the costs’, ‘really good’ and ‘I think they are first class’.

Procedures were in place to ensure that equipment was decontaminated and sterilised. Staff were able to describe these arrangements clearly and had been trained in the prevention of infection. We saw that staff were using gloves, aprons and masks during our visit. Comments made to us by people who had used the service included ‘it’s always clean and tidy’ and ‘immaculate’.

People felt that the staff were competent and professional, with comments made to us including ‘it is a well run practice’ and ‘accommodating and very helpful’. Information on making complaints was available to people who used the service. People said they would feel able to raise any concerns with staff, should the need arise and records showed that feedback from people who used the service was responded to appropriately.