We carried out an announced comprehensive inspection on 20 March 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.

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

Bretton Dental Surgery is situated in a residential area of Peterborough close to a public car park. The practice provides NHS, independent and private dental care to patients. The practice is situated on two floors with one dental treatment room on the ground floor which is accessible for patients with a disability, three treatment rooms on the first floor, a decontamination room, a reception and two waiting areas.

The practice opens from 8am until 6pm from Monday to Thursday and 8am until 12 noon on Fridays. The service is run by Bretton Dental Clinic Partnership. They employ four dentists, a hygienist, a practice manager, four registered dental nurses, a trainee dental nurse and two receptionists.

The practice manager 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.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Staff had received training in handling medical emergencies and had access to medicines and life-saving equipment. We found that the equipment was missing one essential item and the practice took immediate action to rectify this so that all equipment held was in accordance with current guidelines.
• The practice appeared very clean and well maintained.
• Infection control procedures were in place and the practice followed published guidance. However, improvement was needed to ensure that dental materials remained in date for use and dental burs were stored appropriately.
• An accident and incident reporting system had been established and action was taken in response to reported issues. However, opportunities to identify learning and improvement were not always completed thoroughly.
• Patients told us they received good dental care and were able to access convenient appointments. They told us staff were kind and helpful.
• Governance arrangements were in place for the smooth running of the practice.

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

• Review the practice’s systems for investigating and recording incidents, significant events, accidents and complaints to ensure that learning is always identified and used to improve the service whenever possible. Review the process used to record actions taken following relevant patient safety alerts.
• Review the system for identifying and disposing of out-of-date stock in the dental treatment rooms, the use by date for pouched dental instruments and the storage of dental burs.
• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities. Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013
• Review fire safety measures within the building to ensure that escape routes are clearly identified.
• Review the Ionising Radiation Regulations (Medical Exposure) Regulations 2000 and the Department of Health’s: National Radiological Protection Board (NRPB) ‘Guidance notes for Dental Practitioners on the safe use of X-ray equipment’ recommendations in respect of the use of rectangular collimation to limit the radiation dose a patient receives during routine dental X-rays.
• Review the availability of a hearing loop system to support communication for patients who use a hearing aid.