We carried out an announced comprehensive inspection on 10 January 2017 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

Belmont dental practice is situated in County Durham and provides predominantly private treatment to patients of all ages. The entrance is located on the ground floor and the remainder of the practice is on the first floor. There are two treatment rooms, two dedicated decontamination rooms for sterilising dental instruments, a reception, a segregated waiting area, a staff room and general office. Car parking is available within the premises and on the side-streets near the practice. Access for wheelchair users or pushchairs is possible via a portable ramp and a stair-lift is available for aiding people up and down the stairs.

The practice is open Monday and Tuesday 8am - 7pm, Wednesday and Thursday 8am - 5pm and

Friday 8am - 1pm.

The dental team is comprised of two principal dentists, two associate dentists, a dental hygienist, four qualified dental nurses and the receptionist who is also the staff liaison officer.

One of the principal dentists 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.

The practice offers general and specialised dental treatments including dental implants and conscious sedation.

We reviewed 40 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• Staff were very friendly, caring and enthusiastic.
• The practice was visibly clean and an Infection prevention and control policy was in place.
• We saw sterilisation procedures followed recommended guidance.
• The practice had systems for recording incidents and accidents.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patient feedback was regularly sought and reflected upon.
• Patients could access urgent care when required.
• Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
• Complaints were dealt with in an efficient and positive manner.
• Staff received annual medical emergency training.
• Equipment for dealing with medical emergencies reflected guidance from the resuscitation council.
• Staff were aware on how to escalate safeguarding issues for children and adults should the need arise. Contact details were available within their safeguarding policy.
• Staff were involved in providing oral health education to local schools and scouting groups.
• Recruitment and training procedures were not consistent.
• Staff were not fully aware of all relevant safety alerts from the Medicines and Healthcare products Regulatory Agency (MHRA) and Central Alerting System (CAS).

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

• Review the practice's recruitment policy and procedures to ensure recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and to ensure necessary employment checks are in place for all staff. This includes ensuring verbal references are written down and the required specified information in respect of persons employed by the practice is held.

• 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 the practice’s safeguarding protocols and ensure all staff have had training at an appropriate level, in the safeguarding of children and vulnerable adults and understand the prinicples of the Mental Capacity Act 2005.

We spoke with people in the waiting room within the practice. Everybody we spoke with talked positively about the care and treatment they had received at the practice. One person said “They are always asking us if there are things that can be improved." All of the people we spoke with said they had no grounds for complaint.

We found people were involved in making decisions about their treatment and consent was gained before treatment commenced.

There were effective systems in place to reduce the risk and spread of infection.

People we spoke with said they were very happy with the way they were treated by the staff employed by the practice. Comments included “It’s a lovely practice – they (the staff) care” and “Everybody’s very friendly.” We found staff received appropriate professional development and were well supported in their roles. One member of staff told us they felt they were “Working somewhere where they (the provider) take things seriously.”

We saw the provider sought the views of patients by asking them to complete a questionnaire. Responses from patients were generally positive.