We carried out an announced comprehensive inspection on 16 February 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

The practice is owned by Dr. Karl Nightingale.

The practice offers primary care dentistry under the NHS. There are two surgeries located on the ground floor which are accessible to people with mobility issues.

The practice is open Monday to Friday 9am to 6pm, Saturday (by appointment only) 9am to 1pm.

There are three dentists, three dental nurses (one of whom is the practice manager), and two trainee dental nurses.

The owner is the registered provider for the practice. 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 received feedback from a patient about the service via a Care Quality Commission comment card. The feedback was positive about the service they had received.

Our key findings were:

• There was an effective complaints system.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines.
• Patient care and treatment was planned and delivered in line with evidence based guidelines and current regulations.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients could access routine treatment and urgent care when required.
• The practice was well-led, staff felt involved and supported and worked well as a team.
• The governance systems were effective.
• The practice sought feedback from staff and patients about the services they provided.

There was an area where the provider could make improvements and should:

• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK) standards for the dental team.

We spoke with four people who used the service to find out their opinions about the treatment and quality of service they received at the dental practice. One person told us, “It’s absolutely lovely there. They look after you, they speak to you nicely and they have nice manners.” Another person said, “It’s a brilliant place and you get good service.”

Everyone we spoke with made positive comments and indicated that they were pleased with the treatment they received. One person said, “The staff are brilliant, I feel so comfortable with the staff.” Another person commented, “It’s very good. I was with my last dentist for over 30 years and I’ve been here about a year now. My dentist now is just as good, he’s very pleasant and efficient.”

We found that staff received the appropriate support and training for their professional development. One person told us, “The staff appear very well trained, I feel very much at ease with them.”

There were effective systems in place to regularly assess and monitor the quality of service that people received, which included audits and checks of records and equipment.

We saw that people’s personal records, staff records and other records relevant to the management of the practice were kept securely and were accurate and fit for purpose.

We spoke with four people to find out their opinions about the service they received at the dental practice. One person informed us, “It’s very good. Myself, my wife, son and daughter and all our grandchildren go there, it’s very good.”

People told us they were involved in planning their treatment since they were given information and possible options for treatment. We concluded that people who used the service were provided with information about care and treatment available at the practice.

People were complimentary about the treatment they had received. One person informed us, “I’ve used it for 30 years, it’s excellent. I’m happy with it. The dentists have changed, but the service is still good.” We found that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

We concluded that people were cared for in a clean, hygienic environment and there were effective systems in place to reduce the risk and spread of infection.

Staff informed us that they were appropriately trained; however we found that suitable appraisal and supervision arrangements were not fully in place.

We concluded that the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We found that records relevant to staffing and the management of the service were not always accurate and fit for purpose.