Paulsgrove Dental Care is a small practice with, one surgery and a decontamination room. During our visit we spoke with the practice manager, the dentist and the dental nurse.

At our last inspection of this service on 11 March 2013 we found that the provider could not be assured that all their decontamination practices were working in line with the HTM01-05 Decontamination in primary care dental practices.This was because the room used for the decontamination of instruments was also being used as a staff room. We also found that although patients experienced care, treatment and support that met their needs and protected their rights, there was insufficient equipment to support staff.

We carried out this visit to check on the improvements that the provider told us had been made.

During this visit we saw that the decontamination room was no longer used as a staff room. The provider had a system in place to carry out testing of decontamination equipment as recommended in Department of Health guidance. This meant that the provider ensured that decontamination equipment was regularly monitored to check it was working effectively.

At this inspection we checked the medical emergency drugs, the emergency oxygen and the defibrillator, we saw that there were now child sized face masks for the oxygen and a portable manual suction unit was available. The first aid kit had been restocked and was complete and there was a mercury spillage kit in place.

This was a small practice with, one surgery and a decontamination room. The patients we spoke to were happy with the care they had received.

Processes were in place for decontamination of dental instruments. We found that the practice was not working in line with all aspects of HTM01-05 Essential Practice for decontamination as the decontamination room was also used as a staff room.

Staff had appropriate training and were supported in their roles.

There were systems in place to assess risk for the protection of staff and patients but some of these were not up to date. There were arrangements in place to deal with medical emergencies but there was insufficient equipment to support the staff.

We were told that there were issues with the landlords of the premises and this placed some restrictions on the functioning and available space of the surgery.

We were only able to speak to patients and the practice manager in the main building reception area as the practice did not have access to any other private area.

We carried out an announced comprehensive inspection on 26 October 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 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

Paulsgrove Dental Care is under the umbrella of a corporate provider. The dental practice provides mainly NHS and some private treatment and caters for both adults and children. The practice employs a dentist and four supporting staff.

The practice is situated in a shared NHS trust health centre. The practice has one dental treatment room and a separate decontamination room for cleaning, sterilising and packing dental instruments and a reception and waiting area.

The practice manager is the registered manager. 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We collected five completed cards and spoke to three patients. These provided a positive view of the services the practice provides.

We carried out an announced comprehensive inspection on 26 October 2015 as part of our planned inspection of all dental practices. The inspection took place over one day and was carried out by a lead inspector, a second inspector and a dental specialist adviser.

Our key findings were:

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• Patients’ needs were assessed and care was planned and delivered in line with current professional guidelines
• The practice was visibly clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had effective safeguarding processes in place for safeguarding adults and children living in vulnerable circumstances.
• The practice had enough staff to deliver the service.
• Staff recruitment files were organised and complete.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

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

• The reporting mechanism for needle stick injuries should be followed to demonstrate learning outcomes.