We carried out an announced comprehensive inspection on 13 February 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

Bigby Street Dental Practice is situated in Brigg, North Lincolnshire. The practice provides NHS dental treatment to adults and children and offers privately funded treatments. The services include preventative advice and treatment and routine restorative dental care. The practice also has an NHS contract to provide minor oral surgery.

The practice has five surgeries, a decontamination suite, two waiting areas, an X-ray room and a reception area. There are three surgeries, the X-ray room, the reception area, one waiting room and accessible toilet facilities on the ground floor. The other two surgeries and the second waiting room are on the second floor. The practice is fully accessible for wheelchair users and those with limited mobility.

There are three dentists, six dental nurses (one of whom is a trainee and one is currently on maternity leave), two receptionists and a practice manager.

The opening hours are Monday to Friday from 9:00am to 5:00pm. The practice is closed between 1:00pm and 2:00pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

During the inspection we spoke with four patients who used the service and reviewed 46 completed CQC comment cards. The patients were positive about the care and treatment they received at the practice. Comments included staff were friendly, professional and caring. They also commented it was easy to make appointments, the premises was safe and hygienic and treatments were explained well.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed patients were treated with kindness and respect by staff.
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• Patients were able to make routine and emergency appointments when needed.
• The governance systems were effective.
• There were clearly defined leadership roles within the practice and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

• Review the availability of a policy in relation to the use of close circuit television (CCTV) and ensure the practice informs the Information Commissioners Office (ICO) of its use in the practice.
• Review the use of identification tape on instruments.
• Review the security of prescription pads in the practice.

The Bigby Street Dental Practice obtained informed patient consent prior to treatment. Patients said the dentist explained treatment options to them. Clinical assessment of patients informed the planning of their dental care and treatment.

Patients we spoke with told us they were content with their treatment. Comments included, “I see the same dentist all the time; the treatment was definitely satisfactory, and they’ve made another appointment to keep an eye on it,” and “It’s nice and they are all friendly; it’s not been too painful; I see the same dentist.”

Patients commented favourably about cleanliness: “It is really clean,” “I had glasses and an apron to wear and the dentist wore protective equipment,” and “The whole place was washed down between each patient treatment. They used clean instruments and they wore a mask and gloves.”

Patients spoke positively about the staff that worked with them. Patient comments included, “Staff are friendly and very nice to talk to; they always make time for you,” and “The staff were very nice; the dentists are quite informative.” A relative told us, “The staff are really nice and I’ve never had a problem with them.”

Arrangements were in place for auditing the quality of the service. Questionnaires of patients were used although we found patients we spoke with had not completed these. The provider had made arrangements to monitor and improve practice. Procedures for people to make complaints were in place.