We carried out an announced comprehensive inspection on 5 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

Boroughbridge Dental Centre is located in purpose-built premises and provides NHS and private treatment to patients of all ages. There are five treatment rooms, an Orthopantomogram (OPG) room, a decontamination room for sterilising dental instruments, a staff room/kitchen and a general office.

Access for wheelchair users or pushchairs is possible from the ground floor entrance, which leads into the spacious reception and waiting area. Ample car parking spaces are available at the practice.

The dental team is comprised of four dentists (one of which is a foundation dentist), nine dental nurses (four of which are trainees and three cover reception), two dental hygiene therapists and a practice manager.

The practice is open:

Monday – Friday 8am – 5:30pm closing for lunch 1pm – 2pm.

The principal dentist 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 feedback from16 patients. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be very pleasant and helpful; staff were friendly and communicated well. Patients commented they could access emergency care easily and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice was visibly clean and tidy.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Treatment was well planned and provided in line with current best practice guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice sought feedback from staff and patients about the services they provided.
• There were clearly defined leadership roles within the practice and staff felt supported at all levels.

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

• Review the practice protocols for checking emergency drugs and equipment to ensure the recommended medical oxygen cylinder is available in the event of a medical emergency.
• Review the practice’s infection control procedures and protocols to ensure they are suitable giving 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 decontamination equipment management is in place, ensuring all logs are the required type, are completed and up to date.
• 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 storage of prescription pads and prescription only medicines in the practice and ensure there are systems in place to monitor and track their use.
• Review the responsibilities in regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the need to implement a risk assessment for all dental materials used within the practice.
• Review the need for a lone worker policy and risk assessment for staff.
• Review the practice policies to ensure they are regularly updated, practice specific and implement a process for all staff to review.
• Review the practice audit protocols to document learning points and share with all relevant staff and ensure the resulting improvements can be demonstrated as part of the audit process.

We looked at the dental records for six patients. We saw treatment plans were made available to patients and that patients had signed agreement to their plan of treatment.

People's needs were assessed and care and treatment was planned in line with their individual treatment plan. When asked, patients visiting the dental practice told us about their experience of visiting The Bungalow Dental Practice. Comments included “It is very good; my family come here", “It is excellent” and “They are extremely caring and compassionate.”

Patients were treated in a clean and hygienic environment.

Staff received appropriate professional development.

We were unable to view any complaints records at the time of our visit as the provider had not received any recent complaints. We viewed the complaints policy which contained detailed information about the various stages of complaints investigations and the timescales for managing the complaint. We saw the complaints policy was displayed within the reception area and within the practice information leaflet.