We carried out an announced comprehensive inspection on 8 July 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

M R Richards Dental surgery is a dental practice providing NHS and private treatment for both adults and children. The practice is situated in Shanklin, a town on the Isle of Wight.

The practice has one dental treatment room in use and a separate decontamination room used for cleaning, sterilising and packing dental instruments.

The practice is based in an adapted commercial property.

The practice employs one dentist, one dental nurse who also acts as a receptionist and a practice manager who also shares reception duties.

The practice’s opening hours are between 8am and 4pm on Monday, Tuesday and Thursday, 1pm and 6pm on Wednesday and 8am and 12pm on Friday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service.

The practice owner 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.

During our inspection we reviewed 11 CQC comment cards completed by patients and obtained the views of five patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.

• Effective leadership was provided by the practice owner.

• 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 equipment was maintained in accordance with current guidelines

• Infection control procedures followed published guidance.

• The practice manager acted as the safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.

• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.

• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.

• The service was aware of the needs of the local population and took these into account in how the practice was run.

• Patients could access treatment and urgent and emergency care when required.

• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owner.

• Staff we spoke with felt well supported by the practice owner and were committed to providing a quality service to their patients.

• Information from 11 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Review the availability of a hearing loop for patients who are hearing aid users.
• 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.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society

We spoke with five patients most of whom had been with the practice for many years and described the dentist and treatment they received as “very good”. Patients told us they were very happy with the service provided. They said they were given information about their treatment which they said was always explained to them. One said “if I need any treatment It’s always explained to me what needs doing”. They said the dentist asked for their consent before carrying out any procedure. One patient told us they had been very nervous but had “complete confidence” in the dentist. All five patients said they found it easy to get an appointment when they wanted one and usually did not have to wait long before being seen. We were told there was consistency in staff who were very friendly and reassuring.

Patients who used the service understood the care, treatment and support choices available to them. They experienced effective, safe and appropriate care and treatment which meet their needs and protected their rights. The provider had effective systems in place which ensured patients were cared for in a clean and hygienic environment. There were systems to regularly assess and monitor the quality of service patients received. Patients were cared for by staff who completed relevant training and were supported to deliver care and treatment safely and to an appropriate standard.