We carried out this announced inspection on 22 June 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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

Queensway Durham Darlington Oral Surgery Service is in Ferryhill and provides NHS oral surgery treatment to adults.

There is step free access for people who use wheelchairs and pushchairs. Car parking spaces including dedicated spaces for patients with disabled badges are available at the practice.

The dental team includes one specialist oral surgeon, two dental nurses and a compliance/HR manager. There is a full team to support the practice located at the main Billingham location.

The practice rents a surgery within a large dental practice. They have access to a dedicated room for taking Orthopantomogram (OPG) X-rays, a decontamination room for sterilising dental instruments, a recovery room, a staff room/kitchen and a general office

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Queensway Durham Darlington Oral Surgery Service was the compliance/HR manager.

On the day of inspection we collected 16 CQC comment cards filled in by patients This information gave us a positive view of the practice.

During the inspection we spoke with the specialist oral surgeon, two dental nurses, and the compliance/HR manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice hold clinics

Monday & Thursday 9am- 5pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

We identified areas of notable practice as the registered provider demonstrated strong leadership, vision and ethos to support staff and patients. The caring environment, support and well-being awareness was evident to see and the work the staff undertook with local communities was in place and highlighted working in partnership with other organisations.

• We were shown the “tooth troopers” which were used across all sites and supported communities with oral health awareness. They used puppets called Tilly and Toby for children community oral health promotion and Doris and Derek had recently been introduced to support local care homes and dementia care. We were told Dementia friends had worked closely with all of the staff to highlight the importance of communication and support for patients and the Partners were implementing support.

• The Partners provided direct clinical support to refugee camps abroad and they sponsored a nurse to attend if a dentist or specialist provided their services. The service had been well received and they now had waiting lists for patients for when they returned.

• All of the staff had been involved in achieving an energy saving silver award for their work to preserve the environment through their recycling efforts across all locations.

• The Partners were involved with staff well-being and were in the process of implementing yoga session for staff, a daily walk and they provided fruit for staff weekly from local sources. It had been highlighted that if staff required access to counselling service this could have a waiting time and cost associated with this, so free accessible counselling services had been put in place to ensure staff could access service if required. They had recently received an award in the North East as this had enhanced staff well-being and reduced absences.

• Foundation dentists, local dentists and dental nurses were given the opportunity to shadow the services to gain experience as part of their training and development.

• We were told an education centre was in place for all staff to utilise and they had recently upgraded their IT systems to include online training and access to policies. The centre could train dental nurses in sedation, oral health education and radiogrpahy. They also ran courses for dentists who had an interest in services and could offer mentorship and development.