We carried out an announced comprehensive inspection on 9 November 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

Dr John P. Siwek BDS Dental Practice is situated at the junction of Harehills Lane and the A64 York Road in a terraced block of commercial properties. There is one dentist who works a total of 20 hours per week. The dentist is supported by a trainee dental nurse and a receptionist. The premises are not wheelchair accessible; patients requiring wheel chair access can be referred to another practice or to the Community Dental Service. There is one surgery in use upstairs and three unused surgeries.

The practice is open from 8.30am to 12.30pm and 1pm to 2pm Monday to Thursday. The practice also closes for three weeks each summer. The dentist has an arrangement with a neighbouring dental practice to provide cover for when the practice is closed during normal working hours.

For urgent care out of hours, patients are directed to the NHS 111 service which triages the call and passes the details to Local Care Direct who is the out of hour’s provider.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

During the inspection we spoke to three patients and received 41 completed comment cards. Patient feedback was strongly and consistently positive; comments included that staff were professional, caring, friendly and helped patients feel at ease. Many patients gave examples of where the dentist had given clear explanations and spent time discussing treatment options and several said they would recommend the practice to others. Patients also said they could access appointments easily and they found the practice clean.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified or in training and working under supervision and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed that treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed that patients were treated with kindness and respect by staff.
• There was a warm and welcoming feel to the practice.
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• Patients were able to make routine and emergency appointments when needed.
• The governance systems were effective.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

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

• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.
• Review the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely.

Patients that used the practice told us that they were happy with the service provided. They felt they were given enough information about their treatment options and were able to ask all the questions they wanted. They found the staff to be friendly and said they were treated with respect and their privacy was maintained. They told us they did not have to wait long for an appointment.

Feedback from patient’s surveys said they were, "Very happy with the treatment.” “The staff were friendly and helpful" and "The practice was extremely clean and tidy." We saw treatment plans were detailed and included different options where these were appropriate and enabling patients to make an informed choice.