We carried out an announced comprehensive inspection on 14 March 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

Miss K Saxby & Associates - Ampthill Dental Surgery is a general dental practice close to the centre of the town of Ampthill in Bedfordshire.

The practice has four treatment rooms and offers general dental treatment to adults and children funded by the NHS or privately.

The practice now has one principal dentist, five associate dentists and two dental hygienists supported by six qualified dental nurses and 2 receptionists.

The practice is open from 8.30 am to 5 pm on Monday to Friday.

The practice is fully accessible to wheelchair users. The treatment rooms are on the ground floor, and although there are steps from the car park to the rear entrance of the building, there is a temporary ramp available to improve access through the front door.

The practice owner is registered with the Care Quality Commission (CQC) 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We received feedback from 50 patients. These provided a positive view of the services the practice provides. Patients commented on the quality of care, the polite and friendly nature of staff and the cleanliness of the practice.

Our key findings were:

• The practice was visibly clean and clutter free.

• Comments from patients indicated that the staff were kind and caring and were skilled at putting nervous patients at ease.

• The practice met the standards set out in national guidance regarding infection control.

• A routine appointment could be secured privately within a week and a waiting list was available for patients wanting to register for treatment on the NHS.

• Emergency appointments were available daily, and the practice offered a sit and wait service every morning for patients with urgent need.

• The practice had policies in place to assist in the smooth running of the service.

• The practice had medicines and equipment to treat medical emergencies.

• Dentists at the practice used national guidance and standards in the care and treatment of patients.

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• Governance arrangements were in place for the smooth running of the service.

• Appropriate pre-employment checks were being carried out to ensure the service employed fit and proper persons.

• The clinicians were using rubber dam when completing root canal treatment.

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

• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
• 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.

On 11 January 2013, during our visit to Miss K Saxby Dental Practice, we spoke with five people who were seeing dentists that day. All told us that they had confidence in the surgery and were satisfied with the service they received. They told us the dentists explained their treatment options and provided clear information for them to make their own decisions on required interventions.

One person told us, ‘‘I find it fantastic. I am reassured by the care I get and have no problem getting an appointment. The staff are lovely.’’ Another said ‘‘They make arrangements to help me attend the surgery. It’s all those little things that make you feel more comfortable.’’ Another person told us, ‘‘Communication here is very good.’’

The surgery had sufficient processes in place to ensure that treatment was delivered safely. All areas of the building were clean and tidy and there were robust infection control processes in place to ensure people were treated safely.

People told us that they would be confident in discussing any shortfall or complaints if it were necessary.