We carried out an announced comprehensive inspection on 8 March 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

Roger Gott Associates is a dental practice situated in the small village of North Somercotes. It provides services to the whole community. This includes NHS work and those paying privately for treatment. This dentist has been in the village for over 40 years. The practice is situated in part of Somercotes House which is the owners home of which part has been converted into a dental practice from a previous GP surgery. Roger Gott Associates has three part time dentists covering the practice. The practice has a reception area, a waiting area and a treatment room, with staff the office and decontamination room upstairs which is not accessible to the public. The building is accessed at the side door of the building with steps however the practice have a portable ramp for their patients using wheelchairs or those with push chairs or limited mobility.

There are three dentists (two associates) that work part time alongside one full time dental nurse and three part time reception/administrative staff.

The principal dentist is the owner and registered manager of the practice. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered dentists, 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.

The practice provides NHS and private dental treatment to adults and children. The practice is open Monday to Friday from 8.45am and closes at 5.30pm other than Tuesday and Wednesday when it closes at 12.30pm. The practice also closes for lunch daily at 12.30pm until 2pm. Reception cover is provided daily until 5.30pm.

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 received feedback from 49 patients about the services provided. The feedback reflected highly positive comments about the staff and the services provided. Patients commented that the practice was always clean and tidy and that it was safe and hygienic. They said that they found the staff offered an efficient and professional service. They said that staff were polite, helpful and kind. Patients said that explanations about their treatment were clear and that they were given time to ask questions and all options were fully explained. Feedback in relation to patients who were nervous said that staff were reassuring and understanding and that they were made to feel at ease.

Our key findings were:

• There was a process in place for reporting and learning from incidents, accidents and near misses.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in place and staff had access to personal protective equipment.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks.
• Patients were treated with dignity, respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies.
• Governance systems were effective and policies and procedures were in place to provide and manage the service however these had not been reviewed and therefore it was not clear if they were current and up to date.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns although contact numbers for safeguarding teams needed updating.
• All staff were clear of their roles and responsibilities.
• Feedback from patients was positive.

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

• Review safeguarding information to check that contact details are relevant and up to date.
• Review policies and procedures to ensure that they are relevant and up to date. Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.

Everyone we spoke with talked positively about the staff and felt they supported their treatment and care. People told us the staff spoke with them in a calm manner. One person said, "I am quite satisfied with the staff here."

People told us their treatment was personalised to their needs. They told us they had seen staff write notes about them and had completed medical questionnaires. One person said, "All my family come, which I think is testimony of how good the treatment and care is here." People told us they were happy with the standard of cleanliness throughout the practice and had observed staff wearing protective clothing. One person told us, "Staff make sure they wear gloves and are always in uniform."

People we spoke with told us they had confidence in the staff and the treatments they performed. They said the staff knew a lot about different options that they could offer. One person said, "I've been given some good advice about cleaning my teeth a different way."

No one we spoke to had any complaints about the practice. People knew about the complaints system and everyone told us they had nothing but praise for the surgery.