We carried out an announced comprehensive inspection on 23 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

The Dental Surgery provides mostly private dental treatment to adults and has about 2,000 patients on its list. In addition to general dentistry, some cosmetic procedures are also provided including dental implant restoration and teeth whitening. The practice also has a small contract with the NHS to provide general dentistry to children.

The practice has one dentist, two hygienists and a nurse/practice manager. The practice opens from Monday to Thursday between 8am and 5.30pm, and on Friday by appointment only.

The practice’s premises consist of two treatment rooms, a patient waiting area and a small reception office. At the time of our inspection, there were building works in process to enlarge the practice.

We spoke with two patients during our inspection and also received 49 comments cards that had been completed by patients prior to our inspection. All the comments received reflected that patients were very satisfied with the staff, their dental assessments, the explanation of their treatment and the quality of the dentistry.

Our key findings were:

• We received consistently good feedback from patients about the quality of the practice’s staff and the effectiveness of their treatment.

• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation. Patients’ dental care records provided an accurate, thorough and contemporaneous record of patient care.

• The practice was clean and well maintained.
• Infection control and decontamination procedures were robust, ensuring patients’ safety.

• Staff had received training appropriate to their roles and were supported in their continued professional development

• Patients were treated in a way that they liked and information about them was treated confidentially.

• Patients received their care and treatment from well trained and supported staff. These staff received regular appraisal. Staff enjoyed their work.

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

• Improve the recording of, and learning from, significant events.

• Have the gel form of midazolam available so it can be administered quickly in the event of a patient having a fit.

• Secure sharps’ bins to a wall to ensure their safety.

• Cover and protect loose medical items such as matrix bands in treatment room drawers.

• Monitor the fridge temperature used to store the medicine glucagon or change the expiry date on the medication to reflect the fact it has not been kept at the required temperature.

• ensure all equipment needed to summons assistance in the event of an emergency in the disabled toilet is working correctly

• Implement a system to monitor and track referrals made on patients’ behalf to other dental care providers.

• Provide seating with arms and different heights to support people with mobility problems.

• Display information about the practice’s opening times and out of hours services on the front door in case patients visit when the service is closed.

We spoke with the dentist and a member of staff. We spoke with four people who used the service, observed a consultation and read seven sets of treatment records.

Each person told us that the dentist gave them clear information and itemised treatment plans including costs. One person told us that the dentist’s explanations could sometimes be “…a bit quick…” but they also said that they were able to ask for further clarification if necessary. Another person said that the dentist “…always tells me what needs doing.”

People’s treatment records included medical history forms, signed treatment plans and cost estimates. Computerised records showed in detail the treatment and care people had received. We also noted that people’s medical histories were checked regularly. This demonstrated that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

There were effective systems in place to reduce the risk and spread of infection. We observed the nurse undertaking the cleaning and sterilisation of instruments. They followed the practice’s decontamination procedure, dated January 2013, which was clearly displayed in the decontamination area.

The practice was staffed by suitably skilled and experienced staff. A complaints policy was in place, but people we spoke with told us that they had never had cause to make a complaint. One person told us “We haven’t got any complaints at all.”