This service has not been inspected before. We rated it them as outstanding because:

• Staff completed mandatory training relevant to their roles. They were encouraged to do so and this was actively monitored by managers.
• Safeguarding processes were well embedded within the culture of the service. Staff had a good understanding of the signs and symptoms of abuse and neglect. There was good engagement with the trusts safeguarding team.
• Premises and equipment were clean and well maintained. Emergency equipment and medicines were readily available which reflected nationally recognised guidance. X-ray equipment was serviced and maintained in line with the Ionising Radiation Regulations (IRR 2017).
• The service had enough staff with the right qualifications, skills, training and experience to keep people safe from avoidable harm and abuse and to provide the right care and treatment.
• Staff were aware of the process for reporting significant events ad incidents. There were systems in place to reduce the likelihood of wrong site surgery. We saw examples of completed safe surgery checklists and World Health Organisation (WHO) surgical safety checklists.
• Care and treatment was provided in line with current evidence based guidance and standards such as the National Institute for Health and Care Excellence, British Orthodontic Society, British Society of Periodontology and the Faculty of General Dental Practice. Patients were provided with oral health advice in line with the Department of Health’s ‘Delivering Better Oral Health’ toolkit 2013.
• The service was proactive pursued opportunities to participate in audit and research. They carried out audits and research projects which had led to improved patient outcomes. These were at local, national and international levels. These included the use of three dimensional scans to create surgical stents to aid surgery. These had reduced surgery time and recovery times and increased aesthetic outcomes.
• There was good multidisciplinary working. These included within the service and also externally with patients GPs or consultants.
• Patients told us that staff were compassionate and caring. From May 2017 to April 2018 the friends and family test (FFT) response rate for Leeds Dental Institute was 81.3%. The overall percentage of patients who said they would recommend the institute to friends and family over these 12 months was 98.4%.
• The service was responsive to patients’ individual needs. For example, reasonable adjustments had been made to enable wheelchair users or those with restricted mobility to access care. Translation services were available for patients who did not have English as a first language.
• The service monitored referral to treatment waiting times and took action to reduce these if required.
• Leaders had the capacity and skills to deliver high-quality, sustainable care. There were effective governance arrangements in place to support the smooth running of the service.
• There were clear responsibilities, roles and systems of accountability to support good governance and management.
• Staff were proud to work at the service and there was good morale. They were aware of how to raise concerns if the need arose.
• There were good lines of communication with other organisations and the local dental community.
• Learning, continuous improvement and innovation was well embedded within the culture of the service. We were told of new and innovative research such as the “Don’t smile” project. This involved the theatrical performance to disseminate research to at-risk seldom-heard adolescents in areas of social deprivation and high oral health inequality. They were also heavily involved with work with digital dentistry, the genetic function in the development of enamel abnormalities, skeletal tissue repair and regeneration and looking at the link between periodontal disease and rheumatoid arthritis.

However:

• There were issues about dental unit water lines. Testing of the dental unit water lines had identified that many dental chairs showed the existence of colony forming units. Management and staff were aware of the issue and a system was in place to reduce the risks associated with this.
• Mandatory training rates for resuscitation and safeguarding were below the trust target.