We carried out an announced comprehensive inspection on 13 October 2015 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

Carlton Dental Care was registered with the Care Quality Commission (CQC) in April 2014 to provide dental services to patients in north Nottingham and the surrounding areas. The practice provides both NHS and private dental treatment, with approximately 60% being NHS patients. Services provided include general dentistry, dental hygiene, teeth whitening, crowns and bridges, and root canal treatment. The practice is open Monday to Friday 9:00 am to 5:30 pm. Access for urgent treatment outside of opening hours is usually through the NHS 111 telephone line. A separate telephone line is available for patients using a private dental scheme.

The practice has five dentists, one hygienist/ therapist, and six dental nurses. There is a practice manager, a reception manager and one receptionist.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 44 patients about the services provided. We saw that most of the feedback was positive, with only one negative comment. This related to the difficulty with sometimes getting an appointment. This person also said that once they had an appointment the treatment was very good, and they had no other problems. Patients said they were extremely happy with the service provided, and spoke positively about their experience at this dentist and with the whole staff team. Patients said they were treated well at the practice, and that staff were friendly and approachable, they were able to ask questions, and the dentist explained the treatment options and costs.

Our key findings were:

• The practice recorded accidents, significant events and complaints.
• Learning from any complaints and significant incidents were recorded and learning was shared with staff.
• All staff had received whistle blowing training and were aware of these procedures and the actions required.
• Patients said they were happy and satisfied with the dental service they received, and several said they were very happy.
• Patients said they were treated with dignity and respect.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies.
• Emergency medicines, an automated external defibrillator (AED) and oxygen were readily available. An AED is a portable electronic device that automatically diagnoses life threatening irregularities of the heart and delivers an electrical shock to attempt to restore a normal heart rhythm.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Patients’ care and treatment was planned and delivered in line with National Institute for Health and Care Excellence (NICE) guidelines.
• Patients were involved in making decisions about their treatment
• Options for treatment were identified and explored and discussed with patients.
• Patients’ confidentiality was maintained.

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

• Review the use of test strips when using the autoclave.

• Review the condition of the clinical waste bin outside, so that it is either repaired or replaced.
• Review the details of patients’ consent within their records to make sure there is a full and complete record.
• Review the use of rubber dams in accordance with the British Endodontic Society guidance.

• Review the process for recording significant events and complaints are recorded.

We spoke with one patient who told us about their experience of using the service. We also looked at thirteen patient responses to a recent quality audit undertaken by the provider. We spoke with the practice manager and two dental nurses. We looked at treatment records, recruitment records and checked the environment.

We found the dental team were working together to provide a quality service. Checks were made by the provider to ensure the staff team had appropriate professional registration.

Patient's diversity, values and human rights were respected. Patients told us that they were treated respectfully and 100% of the patient responses to the provider’s recent quality survey supported that patients felt they were treated well.

Patients told us they always found the premises very clean. We found that the provider had systems in place to ensure patient’s experienced care in a clean environment and were protected from acquiring infections.