We carried out an announced comprehensive inspection on 12 January 2017 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. Sacha Young provides primary dental care services from Fauchard House in the city of Plymouth, Devon. The practice provides NHS dental services. There are currently five active dental surgeries situated over three floors. (The practice has nine surgeries in total but employs five dentists). Approximately 32,500 patients are registered at the practice.

The staff structure of the practice consists of five dentists. There provider/principal dentist also manages the practice. The dentists are supported by a team of dental nurses and receptionists. Most nurses at the practice are trainees. The practice is also a training practice for dentists in their foundation years after graduating.

The practice is open from Monday to Friday from 9.00am to 6.00pm. There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

The inspection took place over one day and was carried out by a CQC inspector.

One hundred patients provided feedback directly to CQC about the service. Ninety nine patients’ comments were positive about the care they received from the practice. Patients were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received. One patient left mildly critical feedback about the treatment they had received. The principal dentist responded to this feedback by contacting the patient to try and resolve their concerns about the treatment they had received.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• There were effective systems in place to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment phone reminders were available on request 48 hours prior to appointments.
• The provider had a clear vision for the practice and staff told us they were well supported by the principal dentist.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and there was a programme for building maintenance.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke with felt supported by the management team and were committed to providing a quality service to their patients.

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

• Review the practice recruitment policy and procedures to ensure background checks and references for new staff are consistently received prior to staff employment.
• Implement a record summarising the outcome of all complaints received and any learning for the staff team taken forward as a result of complaints.
• Maintain a written record of all fire alarm tests.
• Monitor and respond to patient feedback received via the NHS Choices website.

We received comments from four people who used this dental service. People told us “I am always anxious about visiting the dentist but the friendly staff put me at ease.” Another person told us “Been with the dentist for years, wouldn’t change at all, lovely, treats me well.”

People told us everything was explained and the dentist discussed treatment options. Everyone said they were involved in their treatment plan and had been asked for their consent.

We found that the treatment rooms and instruments were kept clean and hygienic and that regular checks were carried out to ensure the continued safe delivery of the service. Staff told us “I have worked here for a long time and wouldn’t want to work anywhere else.”

Training and support were provided to maintain a safe service. Regular checks were made on machines and systems to ensure safety was maintained.

We spoke with seven patients. All these patients were happy overall with the treatment they had received. Where appropriate they had been given treatment options and the information they needed to be able to make their choice. They felt that their decisions and opinions were respected by the staff.

We found that people were given appropriate information about their treatment. Information was collected and updated about patient's medical conditions to ensure patients remained safe when being treated. Equipment was available and staff trained to deal with medical emergencies.

People were cared for in a clean, hygienic environment.

There was a commitment on the part of the provider to staff training and development and by all staff themselves to remaining appropriately trained and enhance their knowledge and skills. Patient records were compiled and maintained adequately and stored and, where appropriate, destroyed securely.