We carried out an announced comprehensive inspection on 13 December 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

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

St Neots (also known as Market Square Dental Practice) is part of the Oasis Dental Care network. The service provides a range of dental services for mainly private patients which accounts for approximately 75% of their work. The remaining 25% of the dental service provides NHS dentistry. The practice is situated in the centre of the town with several public car parks close by. The practice has five dental treatment rooms and a separate decontamination room for cleaning, sterilising and packing dental instruments. The building is on two levels with dental services provided on the ground and first floors. 

The practice opens 8am to 7pm Monday to Wednesday and 8.15 am to 5.15pm on Thursday and Friday. The practice employs five dentists and a dental hygiene therapist. They are supported by a team of five dental nurses (two of whom also cover reception), one receptionist, a practice manager and a service co-ordinator. The company also employs a field nurse to cover practices in the local area and one field nurse was also based at St Neots.

At the time of the inspection, the practice manager was the registered manager but was due to take up a new post within the company the following week. A new manager had been appointed who would apply to become 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.

We received feedback from five patients either in person or on CQC comments cards from patients who had visited the practice in the two weeks before our inspection. The feedback we received was all positive and patients told us the staff were caring and had a helpful attitude. Patients also told us they were happy with the care and treatment they had received.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties and the equipment was well maintained.
• Staff had been trained to handle emergencies and life-saving equipment was readily available in accordance with current guidelines. Emergency medicines were available in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. We found that a medicine used for the treatment of diabetic patients had not been stored correctly. The practice took immediate action to replace it.
• Infection control procedures were in place and followed by staff.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines
• The practice appeared clean and free from clutter.
• Staff received training and development and an annual appraisal.
• Patients told us they were able to get an appointment when they needed one and the staff were kind and helpful.
• Governance arrangements were effective in monitoring the quality of the service. Action was taken following most completed audits to help make improvements although there was no evidence of an analysis or actions following the last infection control audit. Patient feedback was sought, considered and appropriate actions were taken.

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

• Review the current legionella risk assessment and infection control audit to ensure that ant required actions are completed.
• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references, are suitably obtained and recorded.
• Review the monitoring systems used to ensure staff are up to date with their mandatory training and their Continuing Professional Development.

During our inspection on 30 July 2013 we received many positive comments about the service from the six people we spoke with, many of whom had used the practice for many years. People told us they were satisfied with the treatment they received, that they regularly saw the same dentist and that their appointment times rarely ran late. One person stated: “I’ve been coming here nearly 30 years and never had a problem”. Another told us: “I would definitely recommend the practice, it’s friendly and the wait times are excellent”. People told us they could receive an emergency appointment quickly if needed.

We found that infection control and decontamination processes were good and ensured people were protected from the risk of infection. Staff felt supported in their work and received training to ensure their skills and knowledge were kept up to date. People’s suggestions and concerns were taken seriously and used to improve the service.

The provider was compliant in all outcome areas we assessed and evidence indicated this was a well-run, organised and effective dental service.