We carried out an announced comprehensive inspection on 15th October 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

12 Ripon Road Dental Practice is situated in Harrogate, North Yorkshire and is a partnership. The practice is co-located with another dental practice and they share common facilities including a waiting room and reception areas, staff room and toilets.

It offers a mix of NHS and private dental treatments. The services include preventative advice and routine restorative dental care.

The practice has two surgeries and a decontamination room. There are two dentists and five dental nurses.

The practice is open:

Monday, Wednesday, Thursday and Friday  08:30 – 17:30

Tuesday 08:30 – 18:00

CQC inspected the practice on 22nd October 2013 and asked the provider to make improvements regarding flooring within the decontamination room. We checked these areas as part of this comprehensive inspection and found this had been resolved.

The Practice owner 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.

On the day of inspection we received 46 Care Quality Comment Cards providing feedback and spoke to three patients. The patients who provided feedback were positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be pleasant and efficient and caring and they were treated with dignity and respect.

Our key findings were:

• There was a complaints system in place. Staff recorded complaints and cascaded learning to staff.
• 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, best practice and current regulations.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it, although this was not always recorded.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The governance systems were effective.
• The practice sought feedback from staff and patients about the services they provided.

We identified no regulations that were not being met.

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

• Review the policy for Personal Protective Equipment.
• Implement a policy for lone working.
• Ensure that relevant guidance on personal indemnity cover is followed in respect of dental nurses.

In August 2013 we carried out a scheduled inspection to 12 Ripon Road dental practice. We judged, at that time, that improvements were needed to ensure people were protected from the risk of infection by using appropriate guidance. Following this, the provider wrote to us and told us what they were going to do to address the issues identified. During our follow up inspection in October 2013 we found that improvements had been made.

We saw the decontamination room had been decorated and new, suitable flooring was in place. The room was clean and free from clutter. Changes had been made to the cleaning arrangements at the practice. Records showed arrangements were now in place for the provider to monitor their compliance with HTM-01-05. This is a system designed to assist primary dental services to meet satisfactory levels of decontamination.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. A policy on consent was in place which was followed by staff. We spoke with four people receiving treatment on the day of our inspection and they told us that the treatment was discussed with them at all stages before any treatment commenced.

People's needs were assessed and care and treatment was planned in line with their individual treatment plan. Comments from people included “All my family come here and I recommend it to people” and “It is excellent; I have no concerns at all.”

People told us they had no concerns about cleanliness at the practice. However, people were not always protected from the risk of infection because appropriate guidance had not been followed.

Staff received appropriate professional development. We saw evidence that staff maintained their registration with the General Dental Council (GDC) and maintained their continual professional development which was required to maintain their GDC registration.

The practice had not received any complaints. A complaints procedure was in place for staff to follow. However, this was not made available to people visiting the practice.