We carried out an announced comprehensive inspection on 15 February 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

Alexandra Road is part of Caring Dentistry Limited, the two storey practice is located in the town centre of Wisbech and had completed phase one of a refurbishment plan. The ground floor has two treatment rooms, reception, and waiting area, practice manager’s office, and staff toilet. There are a further three treatment rooms, a decontamination room for cleaning, sterilising, and packing dental instruments, a patient toilet, a cleaning room and a staff room on the first floor.

The ground floor of the premises are accessible to wheelchair users , however, there are no disabled toilet facilities, staff make patients aware of this and sign post them to other local practices if needed. The practice does not have a lift. A free car park, with designated disabled parking spaces, is available very close to the practice.

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.

Six dentists provide NHS and private treatment to approximately 3,500 patients. The practice employs nine trained dental nurses, one trainee dental nurse, and three receptionists.

We received feedback from 15 patients during the inspection process. We received positive comments about the cleanliness of the premises, the empathy and responsiveness of staff, and the quality of treatment provided.

Five patients told us that staff explained treatment options to them well. Patients reported that the practice had seen them on the same day for emergency treatment. Patients commented that the service they received was good, and that staff were always clear about the costs involved in their treatment.

Our key findings were:

• Staff had received safeguarding training and knew the processes to follow in order to raise any concerns.
• Staff had been trained to deal with medical emergencies and appropriate medicines and life-saving equipment were readily available and accessible.
• Infection control procedures were in place and staff had access to personal protective equipment.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits, and risks and were involved in making decisions about them.
• 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 staff felt involved in the management and development of the practice and worked as a team.

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

• Undertake audits relating to X-rays at regular intervals to help improve the quality of service.
• Dental care records should be written to ensure they contain the relevant information needed to reflect patients’ consent, and decisions in relation to their treatment.

All of the people that were spoken with told us that they had the right amount of information to make a decision about their treatment options. They also said that they were treated in a respectful way.

People also said they were very satisfied with the standard and quality of their care and treatment. One person, for example, said that they were treated in an, Excellent” way and experienced no discomfort when being treated for their dental condition.

People were provided with advice to maintain and promote their oral health. Clinical procedures were routinely carried out to assess and review people's dental and physical health.

Effective staff training and cleaning systems were in place to ensure people's health was protected against the risk of acquiring infections from unclean equipment.

People were protected from unsuitable staff because appropriate criminal record bureau checks (CRBs) had been carried out. Staff who did not have such checks carried out, worked with a member of staff who had clear enhanced CRBs. People who we spoke with had confidence and trust in the ability of staff to provide them with safe and appropriate support, care and treatment.

People who used the service were protected from inappropriate and unsafe care due to effective quality assurance systems. There were also opportunities for people to tell the provider of their views about the standard and quality of the service.