We carried out an announced comprehensive inspection on 9 December 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

Established in 2003 and extended in 2011, Elliott McCarthy Dental Care is located in purpose-built premises and provides NHS and private treatment to patients of all ages. There are four treatment rooms, a decontamination room for sterilising dental instruments on each floor, an Orthopantomogram (OPT) room, a staff room/kitchen and a general office. The practice had an upstairs office to receive phone calls for privacy and confidentiality and a patient information room to discuss treatments and options with the treatment co-ordinator.

Access for wheelchair users or pushchairs is possible from step free access entrance with automatic doors which lead into the spacious reception and waiting area. Ample car parking spaces are available at the practice.

The dental team is comprised of four dentists (one of which is a foundation training dentist), seven dental nurses, one dental hygienist, two dental hygiene therapists, three receptionists and a practice manager. The practice also had a visiting Implantologist and a dentist with an interest in endodontics once a month.

The practice is open:

Monday, Wednesday & Thursday 8:30am – 7pm.

Tuesday 8:30am – 5:30pm

Friday 8:30am – 4pm

Saturday 9am – 1pm.

There is no registered manager in place at the practice. 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.

On the day of inspection we received seven CQC comment cards providing feedback and we spoke with four patients. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be caring, reassuring and helpful, the staff were good at communicating information and it was a happy environment. Patients commented they could access emergency care easily and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• The practice was visibly clean and tidy.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in accordance with the published guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Treatment was well planned and provided in line with current best practice guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The governance systems were effective and embedded.
• The practice sought feedback from staff and patients about the services they provided.
• There were clearly defined leadership roles within the practice and staff felt supported at all levels.

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

• Review the practice protocols for checking emergency drugs and equipment to ensure the drugs are the recommended type and the equipment is available to provide medical emergency assistance.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance
• Review the practice registration with the Information Commissioning Office (ICO) in relation to the use of CCTV cameras within the dental practice and ensure all information, assessments and signage are implemented as per the recommendations.
• Review the need for a lone worker policy and risk assessment for staff.
• Review the storage of COSHH materials to ensure they are not accessible to the public and review the COSHH folder to ensure all materials have a safety data sheet and risk assessment in place.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

We spoke with four people who used the service. People said that they were very happy and that they saw the dentist on a regular basis. They confirmed the dentist always explained what they were doing, what they had found during the examination and what the treatment options were. They told us that staff were approachable and that they felt able to ask the dentist questions or make comments about their treatment.

One person we spoke with told us, “The staff are so nice and they make me feel comfortable.” Another person we spoke with told us, “The staff are all friendly.”

Records were up to date and contained information specific to people. Staff told us they took the time to explain treatment options to people. The dentist told us, “It’s important for people to know about their choices and have the time to make up their mind,” and “Our treatment co-ordinator will contact people following appointments to discuss treatment options further if needed.” One person we spoke with told us, “They talk through everything with me.”

Staff we spoke with were aware of the different types of abuse and procedures to follow.

People were treated and supported by, suitably qualified, skilled and experienced staff.

The practice had effective procedures in place to monitor the quality of the service.