We carried out an unannounced comprehensive inspection on 05 January 2016 as we had received concerning information with regard to infection control and the condition of some of the equipment. We asked 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 K Brophy Dental Surgery provides predominately NHS dental services with private treatment options available for patients. The practice has three consulting and treatment rooms, three dentists who are supported by four dental nurses and a student nurse. The practice also has two dental hygienists, who provided preventative advice and treatments on prescription from the dentists. The practice also provides sedation for its patient population and on referral from other practices in the area. This service is facilitated by a visiting anaesthetist. The practice is managed by the principal dentist who is the owner and supports the whole team.

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.

We were unable to review Care Quality Commission (CQC) comment cards completed by patients as this was an unannounced inspection. We did review feedback from patients who had completed the ‘Friends and Family Test’ comment cards and found that the feedback was positive.

Our key findings were:

• Staff reported incidents and kept records of these which the practice used for shared learning.
• The practice was generally clean but there were areas that needed improvement.
• Staff routinely followed protocols with regard to decontamination of instruments.
• Areas of the practice and some of the equipment had not been maintained to a sufficient standard. However this was rectified following our visit.
• Staff had received some mandatory training.
• Radiography was carried out in line with current regulations.
• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.
• The practice had effective safeguarding processes and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice took into account any comments, concerns or complaints.
• Patients were pleased with the care and treatment they received and complimentary about the dentists and all other members of the practice team.

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

• Arrange and carry out regular staff meetings

On this occasion, we did not speak with people using the service as part of our inspection. At our inspection visit of May 2013 we had found that the provider was not meeting the essential standards of safeguarding children and vulnerable adults, cleanliness and infection control, medicines management and recruitment of staff.

We undertook a followup visit and found the provider had made improvements to ensure suitable infection control practices were followed in the surgery. Staff recruitment procedures were adequate and there were suitable procedures for the safeguarding of vulnerable adults and children. Dental products requiring refrigeration were mostly stored appropriately.

People we spoke with told us that they were happy and satisfied with the service provided by the surgery. They said they had been with the surgery for many years and preferred to visit this surgery even though they now lived a fair distance away. They said their dentist kept them well informed, explained the procedures and provided clarification if it was needed. They told us that they had found the surgery to be clean whenever they visited.

We found that the people who used the service were involved in their care and received treatment which was based on an appropriate assessment of their needs. However, we found that the provider did not follow suitable infection control practices and there was a lack of proper decontamination of instruments. Staff recruitment procedures were inadequate and there was a lack of suitable procedures for the safeguarding of vulnerable adults and children. We also noted that the dental products requiring refrigeration were stored inappropriately.