We carried out an announced comprehensive inspection on 8 November 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

Blossomfield Complete Dental Care is a dental practice providing general dental services on a predominantly private basis. NHS services are available to patients under 18 years of age. Additional services were also offered, such as dental implants, cosmetic dentistry and orthodontics. The service is provided by two dentists. They are supported by two dental hygienists, six dental nurses, two receptionists and a practice manager. A further two staff members are responsible for sterilising duties.

The practice is located near local amenities and bus routes. There is wheelchair access to the practice and car parking facilities. The premises consist of a waiting room, a reception area, kitchen, staff room, four treatment rooms, a decontamination room and a dedicated room for taking X-rays. Toilet facilities are also available and these offer full access for patients with disabilities. The practice opened at 8:15am on Monday to Thursday and at 8:30am on Fridays. Closing times varied between 3:30pm and 8pm.

The provider is one of two dentists who co-own the premises from which the practice runs. Both providers are individually registered with the Care Quality Commission (CQC) This report refers only to Dr Skalka’s roles and responsibilities within 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 looked at comment cards patients had completed prior to the inspection. We received feedback from 20 patients and this was very complimentary, however, one patient expressed their dissatisfaction about waiting times. Patients were positive about their experience and they commented that staff were caring, courteous and professional.

Our key findings were:

• The practice was organised and appeared clean and tidy on the day of our visit. Many patients also commented that this was their experience.
• Patient feedback was positive and centred around good quality care and courteous staff.
• An infection prevention and control policy was in place. The decontamination procedures followed recommended guidance. We found that the practice did not hold a blood spillage kit but this was ordered promptly.

• The practice had systems to assess and manage risks to patients, including health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. The practice responded promptly to complete any necessary improvements.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Staff received training appropriate to their roles.

• There was appropriate equipment for staff to undertake their duties. All equipment was well maintained apart from one item used in the decontamination process. This had not been recently serviced but the practice responded promptly once this was brought to their attention.

• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• Practice meetings were used for shared learning but these took place on an irregular basis.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping.

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

• 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). They must also ensure that staff are educated accordingly.
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff. They should also review the frequency of staff meetings as regular staff meetings provide the opportunity to share learning and incidents with the whole team.

During our visit on 15 November we met with the practice manager, the practice administrator and a dentist. We also spoke with a dental nurse, the staff member in the decontamination room and the receptionist.

We spoke with six people who attended the practice. People described the practice as being welcoming and friendly. People spoke very positively about the quality of the service they had received. One person told us, "I was surprised and impressed with their standard of service." Another said they happily drove 35 miles because they have moved out of the area and did not want to change their practice.

People we spoke with told us that everything was always explained to them. One person said, "they give me full explanations which enable me to carry out my side of the partnership."

During our visit we saw the practice was clean and tidy. Processes were in place to ensure that equipment was safe to use and high levels of cleanliness maintained.

The practice had processes in place to monitor people's views about the service offered. People told us they never had cause to complain about the service they had received. People told us they were satisfied with the service and had recommended it to family and friends.

You can see our judgements on the front page of this report.