We carried out an announced comprehensive inspection on 22 March 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

Oasis Dental Care Central - Market Rasen is a dental practice situated in the small market town of Market Rasen in Lincolnshire. The practice is in the old police station that has been adapted for the purpose of dentistry and is situated over two floors. On the ground floor there are two treatment rooms, one of which is on level access and one that is accessed up three stairs. There is a reception desk with a waiting area, a small office area at the back of the reception, staff toilet and a patient toilet, which has been adapted for the needs of disabled patients or those with limited mobility. The first floor has two treatment rooms, a decontamination room, a small staff kitchen area and staff changing room. Waiting areas have high back chairs and chairs with arm rests to enable ease of use for those with limited mobility. The entrance to the practice is at the back of the building from the car park and can be easily accessed by those patients with limited mobility, wheelchair access, or pushchairs via a ramp or steps with handrails.

There are four dentists working in the practice alongside one dental hygienist, one dental therapist, four dental nurses and two trainee dental nurses. There are also two reception staff, a practice coordinator and a practice manager.

The practice manager is the registered manager of the practice. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered dentists, 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 provides NHS and some private dental treatment to adults and children. The practice is open Monday to Wednesday from 8am to 8pm, Thursday and Friday 8am to 7.30pm and on a Saturday morning there is a clinic for private hygiene appointments.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from eight patients about the services provided. The feedback reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy. They said that they found the staff offered an excellent service and had high confidence in the team. They said that staff were efficient and kind. Patients said that explanations about their treatment were clear and that they were given options in relation to the treatment. Feedback in relation to patients who were nervous commented how the staff were understanding and patient; they were made to feel at ease.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in place and staff had access to personal protective equipment.
• The practice had the necessary equipment to deal with medical emergencies, and staff had been trained how to use that equipment. This included oxygen and emergency medicines.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Policies and procedures at the practice were kept under review.
• Dentists involved patients in discussions about the care and treatment on offer at the practice. Patient recall intervals were in line with National Institute for Health and Care Excellence (NICE) guidance.
• 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.
• Patients were treated with dignity, respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Governance systems were effective and policies and procedures were in place to provide and manage the service.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities.
• There was a process in place for reporting and learning from significant events and accidents however the learning and outcome was not documented.

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

• Review the location of sharps bins so that they are out of reach of small children
• Review whistleblowing policy to give staff the option of contacts outside of the organisation or practice such as the Care Quality Commission (CQC) or General Dental Council (GDC).
• Review the process for complaints and significant events in relation to learning from and feedback to staff

As part of our inspection we spoke with six staff and five people who use the service. The people we spoke with were positive about the treament they received. They told us they liked using this service and could find no fault in their care and treatment. They told us the dentist and hygienist always discuss their treatment plan with them and they are involved in decision making.

Staff told us it was a good place to work. One said, “We are a good team and all support each other.” Another staff member said, “I love working here. We all get on so well together.”

One person said, “They are very thorough, they take their time.” Another person said, “I am perfectly happy, the hygienist here cleans my teeth better than they have ever been done anywhere else.”

We saw that staff changed out of their uniforms to take their lunch breaks. One dentist told us, “We are very careful here. We have all received infection control training.”

The people we spoke with told us they were happy with the staff. They said they all did a good job. One person said, “They are excellent.” Another person tols us, “I would recommend them to anyone.”