We carried out a comprehensive inspection of St Peter Street Dental Centre on Friday 9 January 2015. This is part of the Integrated Dental Holdings (IDH) corporate group of dental providers.

St Peter Street Dental Centre provides a full range of NHS and private treatments. An endodontist takes referrals from across the region for root canal treatment, which is largely private practice.

The practice is open from 8.30am till 6pm on Mondays and Tuesdays, 8.30am till 5.30pm on Wednesdays and from 9am till 5.30pm on Thursdays and Fridays. It is in the centre of Tiverton.

Two dentists and a hygienist worked at the practice. A dentist had recently left and another was due to start in the week following this visit.

Patients of all ages and diverse backgrounds are registered, with a higher than average proportion of older patients. The patient list was quite stable. New patients were not being taken on at the time of this visit but staff told us that the books had been opened twice a year for short periods.

Feedback was given by 17 patients who completed our comment cards and we spoke with two patients by phone after the visit.

Patients praised the service they had received, the friendliness of the staff and the quality of the dentistry. One person said they had been a nervous patient but they had been treated with respect and care and received such good treatment they no longer felt anxious. Patients said they had been well informed about their treatment at each visit.

Patients found the environment to be clean and hygienic. Most said they had nothing to complain about but some said they were not happy with appointments being changed or cancelled and with changes to staff.

Our key findings were:

• Patients told us they found their dentist good, efficient and helpful with preventative measures.
• Dentists followed professional guidance for delivering good oral health with respect to assessment of the teeth and soft tissues and recording the treatment they provided.
• Systems were in place to maintain a safe service, including arrangements for infection control and preparedness for dealing with medical emergencies.
• Dentists and staff had attended training to ensure they had the skills they needed and to maintain their registration.
• The premises, though not suitable for wheelchair users, were well maintained, clean and attractive.
• A new practice manager had been recently appointed with the skills and knowledge to implement appropriate policies and ensure procedures were followed to ensure a safe and effective service.

There were areas where the provider should make improvements:

The provider should

• Ensure audits of X-rays are completed at 12 monthly intervals or sooner and that the results of these are acted upon.
• Ensure that staff clean the boxes used to bring instruments to be decontaminated and then return them promptly to treatment rooms.
• Ensure measures required by the Legionella risk assessment are carried out.
• Store all medicines that need to be kept chilled, including glucagon, in the refrigerator.
• Keep a record of the temperature of the medicines fridge.
• Ensure written evidence of immunity to hepatitis B is available for all staff.
• Carry out an assessment of the premises in accordance with the Disability Discrimination Act 2005.

This was the practice’s first inspection since dental services were required to register with the Care Quality Commission.

During our inspection we checked and were assured that people using the dental practice had access to examinations in private. We asked people how they were involved in their treatment planning and whether they were invited to give feedback about their experiences. We met and spoke with staff and checked records. We found that patient and staff records were completed well. We toured the premises and were satisfied that people received safe and effective treatment in a clean environment. We looked at staff recruitment processes.

At the time of our visit to the dental practice not all necessary checks had been carried out before employing one staff member. However, the practice manager took immediate action to resolve the gaps in information so that patients were not put at risk.

Following the visit we contacted, with their permission, people who had attended the practice the day of our visit. We spoke by telephone with two people. Both expressed satisfaction with the practice and treatment they had received there.