We carried out an announced comprehensive inspection on 22 December 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

North Road dental practice has been providing NHS dental treatment for over 10 years to patients of all ages. The practice is situated in a residential area in Boldon, Tyne and Wear. There are three treatment rooms, a dedicated decontamination room for sterilising dental instruments, two waiting areas, a reception and a staff kitchen. Car parking is available on the side streets near the practice. Access for wheelchair users or pushchairs is possible via a portable ramp at the front entrance.

The practice is open

Monday and Friday 0830 -1700, Tuesday 0900 -1800, Wednesday & Thursday 0900 -1700 and alternative Saturdays 0900 - 1200. 

The dental team is comprised of two principal dentists, an associate dentist, a dental hygienist, five receptionist/qualified dental nurses (one of whom is the practice manager) and two trainee dental nurses.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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 reviewed 25 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• Staff were very friendly and enthusiastic about their work.
• The practice was visibly clean and free from clutter.
• The practice had systems for recording incidents and accidents.
• Staff received annual medical emergency training.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patients could access urgent care when required.
• Complaints were dealt with in an efficient and positive manner.
• An Infection prevention and control policy was in place. We saw sterilisation procedures followed recommended guidance.
• The provider did not have all emergency medicines and equipment in line with Resuscitation Council (UK) and the British National Formulary (BNF) guidance for medical emergencies in dental practice.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review availability, management and storage of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), the General Dental Council (GDC) standards for the dental team and the British National Formulary (BNF) guidance for medical emergencies in dental practice.
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.

• Review the practice responsibilities in regards to the Control of Substances Hazardous to Health (COSHH) Regulations 2002 to ensure all documentation is present and up to date and staff understand how to minimise risks associated with the use of and handling of these substances.

• Review its audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.
• Review the need to install emergency lighting within the premises in accordance with the Regulatory Reform (Fire Safety) Order 2005.
• Review the practice’s procedures and protocols for ensuring staff have access to medical emergency equipment whilst undertaking domiciliary visits.
• Review the requirements by the Department of Health in Information Governance training and learning.

When we looked at how the people who were using the service were supported to express their views and be involved in making decisions about their care and treatment. We found detailed records and on speaking to them they told us; “I have had my treatment explained clearly to me.” There were detailed treatment plans and patient records which included the options discussed and the reasons for the selection of the treatment delivered.

Peoples’ needs were assessed and the treatment was planned and delivered to address peoples’ individual needs. Patients told us that they were pleased with the care and; “the practice has been fantastic.”

People were protected from the risk of infection because appropriate guidance had been followed for example a well organised and well managed decontamination room. Staff we spoke with understood how to follow best practice guidance for reducing the risk of cross infection.

People were cared for, or supported by, suitably qualified, skilled and experienced staff who had been subject to a selection process and had been checked to make sure they were suitable to deliver the service safely.