We carried out this announced inspection on 13 July 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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

Andrew Abraham dental practice is in Blackhall Colliery, Hartlepool and provides NHS and private treatment to adults and children.

The practice is housed in a two storey building and currently has one ground floor surgery. The upper floor is undergoing refurbishment and expansion.

There is a portable ramp for people who use wheelchairs and pushchairs; the ground floor surgery cannot accommodate wheelchairs due to doorway restrictions. Car parking spaces are available near the practice.

The dental team includes the principal dentist and three dental nurses who also cover reception duties.

The practice is owned by an individual who is the principal dentist there. They 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 collected 32 CQC comment cards filled in by patients and spoke with one patient. This information gave us a highly positive view of the practice.

During the inspection we spoke with the principal dentist and three dental nurses / receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday, Tuesday, Thursday and Friday 0900-1715 and Wednesday 0900- 1245.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review the practice’s fire and legionella risk assessments to ensure their protocols and procedures are in line with the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and the Regulatory Reform (Fire Safety) Order 2005.
• Review the practice’s procedures for storage, monitoring and disposal of their materials, medicines and equipment giving due regard to guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review practice's safeguarding policy and ensure the policy contains the appropriate referral contact details.
• Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the practice’s radiography procedures and protocols to ensure compliance with the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000 and have due regard to related guidance.

We found Andrew Abraham dental practice was compliant against outcome 14, supporting workers. Staff had received appropriate training for their job role.

We spoke with three patients from the practice. They told us:

“Its brilliant, I can’t fault the service”,

“I have been coming here for over 60 years and its excellent” and

“If I ever had any complaints I would tell them straight away”.

Staff told us:

“I love working here”,

“I love the people”, and

“I know everyone who comes here, it’s a small village”.