We carried out an announced comprehensive inspection on 31 January 2017 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

West Earlham Dental Health Practice is a small, well-established dental practice that provides primarily NHS treatment to adults and children. The team consists of two dentists, two dental nurses (one of whom is also the practice manager), and a receptionist. The practice has two dental treatment rooms, a reception/waiting area, and a small staff room. It opens from 9am to 6pm on Mondays; and Tuesdays to Fridays from 8.45am to 5pm.

At time of inspection, the principal dentist (who was also the owner) was registered with the Care Quality Commission (CQC) as an individual. 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. However, an application to change the status of the practice to a partnership had been submitted to us.

Before the inspection we sent comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 48 patients.

Our key findings were:

• Information from 48 completed Care Quality Commission comment cards gave us a positive picture of a friendly, professional and caring service. Patients received clear explanations about their proposed treatment and were actively involved in making decisions about it. They were treated in a way that they liked by staff.

• Staff had received safeguarding training and took action to protect vulnerable patients when needed.

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Good oral health was actively promoted to patients by staff.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result

• 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 legionella assessment and ensure that all recommendations are implemented

• Review the practice's recruitment policy and procedures to ensure references for new staff and employment interviews are recorded.
• Populate the radiation protection file with all relevant details

We spoke to three people while they waited to see the dentist. We also observed treatment being given to one person, with their permission.

People told us that they felt safe in the surgery and were confident that they could raise any concerns with the staff. They told us that they were always given detailed explanations of their treatment plans and that they were able to discuss the plans with the dentist. This showed that people expressed their views and were involved in making decisions about their care and treatment.

We saw staff treating people politely and with respect. Each person we spoke with was positive about the practice. One person described the staff as "excellent.” Another told us that the dentist "…has really built my confidence."

People were offered treatment in a clean and hygienic environment. The practice was well decorated and appropriately furnished. We looked at both of the practice's treatment rooms which were well-equipped and laid out in a way that minimised the risk of cross infection. The practice occupied a single-storey building and had good accessibility for people who used wheelchairs.

Staff were supported to undertake the training required to maintain their professional registration and their standard of practice. There was an effective complaints policy in place. The practice undertook regular surveys to gain an understanding of the experience of people who used the service.