We visited the service on 07 February 2012. We spoke with two dentists, the practice manager and the decontamination staff member.

During this visit we did not have the opportunity to speak to any patients. However we did look at the patient surveys results that had been completed, without exception all patients were happy with the service they had received.

The practice manager informed us that the practice followed The General Dental Council booklet Standards for dental professionals. ‘Respect Patients’ Dignity and Choices’.

The practice manager said all patients received personalised care, treatment and support through very careful coordinated assessment that reflected their needs, preferences and diversity.

The practice manager said the practice ensured that national and local guidance about safeguarding people from abuse would be made available and accessible to all staff. She assured us that that all staff would be trained to ensure they understood all aspects of the safeguarding processes.

We spoke with the practice manager, nurses and dental surgeons who explained to us in detail about the practice procedures on the prevention and control of infections.

Staff spoken with told us that they had attended training in the decontamination of equipment and infection control. Staff said they felt confident with the procedures and that there was additional guidance to follow if needed. Staff were able to show us the decontamination process and describe how the equipment was monitored to ensure it was working efficiently.

The practice manager said that there were detailed policies and procedures in place for the safe use of emergency medication. She said that all staff were aware of these and that they had been trained to use emergency dental equipment. She explained all patients were asked about their medical history and any known allergies including previous reactions to local anaesthetics and antibiotics etc.

When we spoke with the practice manager, nurses and dentists at the practice, they told us there were very robust procedures and measures in place to keep people safe.

We spoke with the practice manager and two dentists who told us how the practice supported staff through training, peer group support and appraisals to make sure they were working to the best clinical guidelines for their professions.

Staff spoken with told us that they were very happy working at the practice and that they felt they received a good level of training and support.

The practice manager and the dentists clearly explained the systems that the practice had in place to check quality and to manage risk.

We carried out this announced inspection on 29 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. They did not provide any information of concern.

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

Shotley Bridge Dental Care is in Consett and provides NHS and private treatment to adults and children. The practice is housed in a single-storey building with level access for people who use wheelchairs and pushchairs. Car parking spaces are available in front of the building and a practice car park is present across the road.

The dental team includes two principal dentists, the practice manager, three associate dentists, a foundation dentist, six dental nurses, a trainee dental nurse, one dental hygiene therapist and four receptionists. The practice has five treatment rooms.

The practice is owned by an individual who is one of the principal dentists there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 23 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with both principal dentists, two dental nurses, the dental hygiene therapist, two receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 0900 – 1900

Tuesday 0900 – 1800

Wednesday and Thursday 0800 – 1800

Friday 0800 – 1730.

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. .
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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.
• Staff felt involved and supported and worked well as a team. Well-being and team days were organised annually to allow all staff to participate in social activities outside of work.
• A monthly “reward scheme” was in place. Staff that had particularly performed well, displayed an act of kindness or needed personal support were rewarded each month.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice was involved in oral health promotion and awareness projects.

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

• Review the practice's recruitment policy and procedures to ensure they are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Review the practice’s fire risk assessment to ensure their fire safety protocols and procedures are in line with the Regulatory Reform (Fire Safety) Order 2005.
• 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 the practice’s procedures for storage and monitoring of their medicines, medical emergency drugs and equipment giving due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice's policy and procedures giving due regard to the Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken for materials held on-site.