We carried out an announced comprehensive inspection of Euxton Dental Practice on the 22 September 2015 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 services in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective services 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.

Euxton Dental Practice is part of the IDH group (Integrated Dental Holdings) a national company which operates 650 dental practices across the United Kingdom. The practice provides dental services for NHS and a small number of private patients.

The service is provided by four associate dentists and one dental hygienist who are supported by five registered dental nurses, three trainee dental nurses, two receptionists and a practice manager. The practice is located within a converted building which is single storey and offers disabled access to the waiting area and treatment rooms. The practice is located centrally within the village of Euxton close to local amenities and bus services. Opening hours are Monday to Friday 8.30am to 5.30pm.

The practice manager has submitted an application to become registered manager which is being processed by CQC. 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.

On the day of inspection we spoke with two patients who used the service and reviewed 20 CQC comment cards that had been completed by patients prior to the inspection. The patients we spoke with were happy with the care and treatment they received at the practice. They told us they were given information about treatment options and found the staff to be polite and they were treated with dignity and respect.

Our key findings were:

• The practice had systems to assess and manage risks to patients, including safeguarding, staff recruitment and the management of medical emergencies.

• The practice carried out oral health assessments and planned treatment in line with current best practice guidance, for example from the Faculty of General Dental Practice (FGDP).

• Dental care records we looked at were detailed and showed on-going monitoring of patients’ oral health.

• Staff received training appropriate to their roles. Information of care and treatment options and support was available to patients, for example information about the cost of treatment.

• Patients told us the staff were polite and respectful. Treatment options were explained fully and patients commented they felt involved in their treatment and that it was fully explained to them.

• Patients were able to make routine and emergency appointments to suit them. There were clear instructions for patients regarding out of hours care.

• There was a complaints system in place and there was an openness and transparency in how these were dealt with.

• The practice had clear lines of accountability and staff told us they felt well supported and able to raise concerns or make suggestions.

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

• Produce an action plan detailing how they might achieve best practice in respect of the decontamination of instruments in line with guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

• Regularly update the policies and procedures for infection control in accordance with Health technical Memorandum 01-05 (HTM 01-05).
• Carry out infection control audits at six monthly intervals in accordance with HTM01-05.

We spoke with a range of people about the quality of service provided. They included, dental practitioners, the practice manager, dental nurses and three patients who were receiving treatment from different dentists. This helped us to gain a balanced overview of what people experienced.

During our discussions with patients we received very positive feedback. They told us they were happy with the care and support shown to them during the course of their treatment. We found the practice to be clean and hygienic and robust systems were in place to assess and monitor the quality of service provided.

Comments from patients included:

"They (the staff) are all very friendly. Some of them have been here for a long time and they know me by name now. Yes always very friendly and helpful."

"All the staff are very polite. They are brilliant. I would never go to another dentist."

"The staff here are so polite. All of them. They are very kind too. They respect me and are interested in me as a patient."

People we spoke with felt they were given enough information about their treatment options and were always given the opportunity to make informed choices. Patients found the staff to be friendly and reported that they felt safe whilst treatment was being delivered. None of the people we spoke with had any concerns about the standard of care they were receiving. We did not have any concerns about any of the outcome areas we assessed.

We spoke to a range of people about the service. They included, dentist practioners, the manager, area manager, practice nurse, receptionist and patients waiting for treatment, in order to gain a balanced overview of what people experienced.

During our discussions with patients we received very positive feedback. They told us they were happy with the care and support shown to them during the course of their treatment.

Comments from patients included:

" I have been a patient here since I was a little girl. I now live in Manchester, but have stayed with this surgery. I have had loads of dental treatment here and I am confident in the dentist and the staff. Some of them have known me for years."

"The lady on the front desk is very good at giving us the right information. I was asked when I first came here about any medical conditions and any tablets I was taking. I filled in a form."

People we spoke with felt they were given enough information about their treatment

options and were kept informed throughout the stages of the treatment. Patients found the staff to be friendly and reported that they were treated with respect and dignity. None of the people we spoke with had any concerns about the standard of care they were receiving.