We carried out an inspection of this dental practice on 24 September 2013. We found a number of shortfalls with regards to the way the practice was being managed, that could have an impact on the care and treatment people received. The provider was requested to provide an action plan to tell us what measures they would take to address the shortfalls identified at the last inspection. The provider did not respond to this request. This follow up inspection was carried out to establish what action the provider had taken to address the shortfalls identified.

During this inspection we spoke with the provider, practice manager and a dental nurse. We did not speak with people who use the service as this inspection was to look at systems and practices implemented to address the shortfalls identified at the last inspection. The dental team consisted of a practice manager, five dentists, one hygienist and nine dental nurses.

The dental records we looked at showed that people’s consent was obtained before they received treatment.

People’s medical history was reviewed but there was a lack of consistency to ensure that the computer system was up dated with this information.

Staff were provided with some support to undertake their role but this was insufficient to ensure all staff’s training and development needs were met appropriately.

This practice was located on the ground and first floor level and was accessible to people who have restricted mobility. Ramp access was available but there were no disabled parking bays and toilets were situated on the first floor. The premises consisted of five treatment rooms and a reception/waiting area. The dental team consisted of a practice manager, five dentists, one hygienist and eight dental nurses.

During this inspection we spoke with the practice manager, the registered provider, two dental nurses and seven people who used the service.

We found that people were informed of their treatment options but their consent for treatment was not always obtained. One person who used the service said, "My consent for treatment has never been asked for.”

Dental records showed the treatment people had received but we found that the delay in follow up appointments could place their oral health at risk.

Staff had received safeguarding training and had a good understanding of how to protect people from potential abuse.

We found that the decontamination process for dental instruments was satisfactory.

Staff had access to relevant training to ensure they had the skills and competence to undertake their role but they were not provided with relevant support or supervision. However, one person who used the service said, “The staff are good and very polite.”

Dr Gibbons & Associates Dental Surgery provides ground and first floor facilities; the ground floor comprises reception/waiting area two treatment rooms and a hygienist room. Located on the first floor were two treatment rooms, toilets and a decontamination room. There are no toilets located on the ground floor. Ramp access is available at the front of the premises and there are limited car parking facilities.

The practice has four dentists, a hygienist, nine dental nurses and a practice manager.

The practice manager confirmed that appropriate safety checks had been carried out to ensure the suitability of staff who work at the practice.

The absence of on going essential staff training does not ensure that staff will have the skills or competence to deliver an effective service.

We found that staff had a good understanding of the decontamination of instruments to ensure people are not placed at risk of contracting avoidable infections.

We spoke with five people who had recently accessed the service; these were some of their comments:

“My dentist always explains what treatment I need and they always listen to my views.”

“I’m a nervous patient and my dentist is very reassuring and explains everything to me.”

“The practice always seems clean and tidy.”

“My privacy and dignity is always respected.”

“The service I receive is fantastic and I have every faith in the staff.”

“I’m quite happy with the service provided.”