We carried out an announced comprehensive inspection on 31 October 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

This practice provides NHS treatment to patients of all ages.

The dental practice is based in a grade 2 listed building in the centre of Ambleside, Cumbria.

The practice has two treatment rooms, a decontamination room, office, waiting room with separate reception area and ground floor toilet facilities. There is public parking available opposite the practice.

The practice has two dentists, one dental nurse and two trainee dental nurses/ receptionists.

The practice is open Monday-Friday 8:30am-5pm, with the exception of Wednesday when the practice closes at 1pm.

The principal dentist is registered with the Care Quality Commission as an individual. 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.

We received feedback from ten people during the inspection about the services provided. Patients commented that they found the staff friendly, caring and that all the staff listened to them and took appropriate action. They commented that the dentists were knowledgeable and that they were always given good and helpful explanations about dental treatment. Patients commented that the practice was clean and comfortable.

Our key findings were:

• The premises were visibly clean and free from clutter.
• Staff followed current infection control guidelines for decontaminating and sterilising equipment.
• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

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

• Review X-ray grading procedures to ensure only staff who are appropriately trained review the quality of the X-rays.

• Review the equipment used to transport dirty instruments for decontamination and the frequency of flushing water lines in line with Health Technical Memorandum 01-05 (HTM 01-05).

People we spoke with confirmed that the dentists and dental nurses always explained what they were going to do. We saw staff speaking to people in a respectful manner and staff we spoke with understood the requirements for privacy, dignity and confidentiality. People told us that they were "very happy" with the level of information they had received. We found that people were able to express their views and were involved in making decisions about their care and treatment. There was also strong agreement that staff were “very friendly”. One person told us; “Staff are all very good, they are all pleasant and friendly,” whilst another person told us; “They always tell me what I need to know and explain everything before they do anything.”

The practice had appropriate equipment to support people in the event of an emergency. The practice facilities were clean and well maintained with appropriate floor and surface coverings. We found that staff received appropriate professional development and were able to obtain further qualifications. Staff confirmed they had on-going formal appraisal. We found that the practice had an effective system in place to monitor the quality of care provided.