We carried out an announced comprehensive inspection on 2 November 2015 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 Raphael’s dental practice is located in the town of Upholland and has 10.000 patients. The practice provides predominantly (90%) NHS primary dental care and treatment and a small amount (10%) of private treatment to patients living in the surrounding area.

The staff team at the practice consists of two principal dentists, three associate dentists, two dental hygienists, three registered dental nurses, a trainee dental nurse and a practice manager. The practice manager told us their aim is to be ‘a caring team for a healthy smile’.

The practice opening times were displayed in the practice and in the patient leaflet. The practice opening hours are Monday to Wednesday from 9am until 5.30pm, Thursday from 9am until 7.30pm and Friday and Saturday from 9am until 1pm. The practice closed for lunch from 1pm until 2pm Monday to Thursday.

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 spoke with four patients who used the service on the day of our inspection and reviewed 19 CQC comment cards that had been completed by patients prior to the inspection.

Our key findings were:

• Providing patients with caring, compassionate and dignified care was considered as a priority by all members of staff. There was a clear focus on improving the quality of care for patients.

• Patients received clear explanations about the treatment options, any costs, benefits and risks to ensure they could make informed choices.

• The practice was well-led and all of the staff were enthusiastic and proud to be part of the team.

• There was a designated lead for safeguarding. Staff had received training in relation to child protection and safeguarding adults. They knew how to recognise the various signs of abuse and how to report their concerns.

• Feedback from patients about the way staff treated them in terms of understanding, dignity and respect was extremely positive.

• There were appropriate infection control procedures in place to minimise the risk and spread of infection.

• Patient’s needs were assessed and care was planned and delivered in line with current best practice guidance for example from the National Institute for Health and Care Excellence.

• There was a clear vision for the service and staff told us they were well supported by the management team. Staff felt well supported and were committed to providing a high quality service to their patients.

• There was appropriate equipment and emergency medicines available to enable the staff to respond to medical emergencies. Staff knew where to access this equipment and had been trained to respond to medical emergencies.

• There were effective governance systems in place to ensure the smooth running of the practice.

• A range of clinical and non-clinical audits were carried out to continually monitor the quality of services.

• All clinical staff were supported to maintain their continuing professional development.

• There were robust systems in place to identify, investigate and learn from incidents relating to the safety of patients and staff members.

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

Ensure the three damaged stools in the treatment rooms are repaired or replaced to minimise the risk of cross contamination.

During our visit to St Raphael's Dental Practice we spoke with three patients and the parent of a child visiting the surgery. Everyone was very complimentary about the staff team and told us their dental needs were being appropriately met. They said they were able to make informed choices about their treatment and their privacy and dignity was always respected.

Comments included:

"This dentist is fantastic in comparison to others I have been to."

"The staff are really helpful and they are lovely with my little boy."

"The dentist is so friendly. He is great. He always explains things well and the rest of the staff are very helpful too."

"Everyone here is friendly and they all make me relaxed when I visit. It is a very professional service."