We carried out an announced comprehensive inspection on 6 January 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

St Owen Dental Studio is situated in Hereford city centre and provides NHS and private treatment.

The dentist moved from their previous premises to the current building early in 2015. This was to ensure they were able to provide suitable access for patients with mobility difficulties and for families with pushchairs and buggies.

The practice has one dentist, one dental nurse and one receptionist. The practice currently has one dental treatment room and a decontamination room for the cleaning, sterilising and packing of dental instruments. There is an additional room which the dentist hopes to equip as a treatment room in the future. The practice is all on ground level with a ramp and handrail to the front entrance and staff and patient toilets which are both fully equipped for people with physical disabilities.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to tell us about their experience of the practice. We collected 10 completed cards and looked at 16 recent NHS Friends and Family forms which were available at the practice. Patients were positive about the practice and their experience of being a patient there. They said they could not fault the service they received and several commented that the practice was excellent. Patients said the practice’s new premises were pleasant and very clean and were an improvement on the previous facilities. They described the staff as helpful and unhurried, and the dentist as kind and gentle. All 16 patients who filled in a Friends and Family form had selected the option confirming that they were ‘extremely likely’ to recommend the practice.

Our key findings were:

• The practice had a health and safety policy, relevant safety related risk assessments and an accident book. They did not have a policy or an established process for reporting and recording significant events but staff confirmed none had occurred.
• The practice was visibly clean and arrangements for infection prevention and control were well organised.

• The practice had safeguarding guidance and information available for staff and the practice team were aware of their responsibilities for safeguarding adults and children.

• The practice had recruitment policies and procedures to help them check the staff they employed (including locums), were suitable. The policy did not fully reflect the requirements set out in the regulations.

• Dental care records provided adequate information about patients’ care and treatment but the amount of detail recorded was inconsistent.

• The dentist and dental nurse were appropriately qualified and arrangements were in place for them to maintain their continuous professional development as required by the General Dental Council.

• Patients were able to make routine and emergency appointments when needed.

• The practice had a suitable complaints procedure and information about this was available for patients.

• Because the staff team was so small, the management and governance arrangements were largely informal. The dentist recognised the benefits of developing more structured arrangements to help them manage and develop the practice in future.

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

• Establish a policy and processes for reporting and recording significant events to ensure that when incidents happen they are investigated, used to make improvements and recognised as opportunities for shared learning within the team.
• Establish an effective system for the stock control of emergency medicines and equipment .

• Review the storage arrangements and the records kept for temperature sensitive medicines.

• Review and update the staff recruitment policy to reflect the requirements set out in Regulation 19(3) and Schedule 3 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014. This should include the arrangements for locum staff whether obtained through an agency or direct by the practice.
• Update the health and safety policy to reflect the fire safety arrangements at the new premises. This should specify the respective responsibilities of the landlord and the provider.
• Review the practice’s protocols for quality assurance of X-rays taken giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR (ME) R) 2000 and Ionising Radiation Regulations (IRR) 99.