We carried out an announced comprehensive inspection on 22 August 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

Ravat & Ray Dental Care (Ormskirk) Ltd offers mainly NHS treatment to patients of all ages and some private dental care services. The services provided include preventative advice and treatment and routine and restorative dental care. The practice also provides minor oral surgery and emergency out of hour’s dental care to patients in the West Lancashire area.

The practice has five dentists, seven qualified dental nurses, a decontamination nurse and a trainee dental nurse; in addition to a practice manager and two receptionists. The practice is a training practice for dental therapists and currently has four trainee dental therapists working there two days each week.

The practice is located in the West Lancashire Health Centre which is based in Ormskirk District Hospital. The practice has five dental treatment rooms, a dedicated decontamination suite and waiting and reception areas; in addition to office and storage facilities. There is wheelchair access and a large patient car park. Opening hours for the practice are from 8.00am until 6.00pm each week day. Emergency out of hours dental services are provided from 6.30pm until 10.00pm each Tuesday and Thursday evening.

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.

We viewed 23 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. In addition we spoke with two patients on the day of our inspection. We reviewed patient feedback gathered by the practice over the last 12 months. Feedback from patients was positive about the care they received from the practice. They commented that they had confidence in the dental services provided.

Our key findings were:

• We found the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding, recruitment and the management of medical emergencies.

• The practice had procedures in place to record, analyse and learn from significant events and incidents.

• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Patients were able to make routine or emergency appointments when needed. There were clear instructions for patients regarding out of hours care.
• The dental practice had effective clinical governance and risk management structures in place. There were systems to monitor and continually improve the quality of the service; including a programme of clinical and non-clinical audits.

• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice owners.

• The practice had an accessible and visible leadership team with clear means of sharing information with staff.

On the day of inspection we identified the following notable practice

• The practice is proactive about providing patients with information about their oral health and general wellbeing. The practice manager told us they promoted specific national and local campaigns each month.
• Each treatment room had details of local support groups for patients’ health and wellbeing such as bereavement counselling, dementia care and smoking cessation. This helped staff to signpost patients to receive support and information from local services.
• The practice seeks to involve and listen to patients. In addition to carrying out patient surveys they arrange a patient engagement meeting annually to share information and listen to patients’ suggestions and concerns.