We carried out an announced comprehensive inspection on 16 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

Bollington Dental Practice is located close to the centre of Bollington and comprises a reception and waiting room, one treatment room and patient toilet facilities on the ground floor, and a further two treatment rooms, a waiting room and a decontamination room on the first floor. Parking is available in an adjacent car park. The practice is accessible to patients with disabilities, limited mobility, and to wheelchair users.

There is one small step at the front entrance to the practice with a handrail positioned alongside to assist patients with limited mobility. The provider has a ramp available to facilitate access to the practice for wheelchair users.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday to Thursday 8.30am to 5.15pm, Friday 8.30am to 4.00pm, and every alternate Wednesday until 7.00pm. The practice is staffed by a principal dentist, a practice manager, two associate dentists, two dental hygienists, four dental nurses, one of whom is an apprentice, and two receptionists.

The principal dentist 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.

We received feedback from 31 people during the inspection about the services provided. Patients commented that they found the practice excellent , and that staff were professional, friendly, and caring. They said the clinicians listened to them and they were always given good explanations about dental treatment and excellent oral health advice. Patients commented that the practice was clean and comfortable.

Our key findings were:

• Staff had received safeguarding training, and knew the processes to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• The premises and equipment were clean, secure and well maintained.
• Staff followed current infection control guidelines for decontaminating and sterilising instruments.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current standards and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.
• The practice did not have procedures in place to record, analyse and learn from significant events and incidents.

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

• Introduce a system for the recording, investigating and reviewing of incidents and significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the storage of records relating to people employed, and paper dental care records to ensure they are stored securely.
• Introduce an effective system to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities, specifically in relation to the display of warning signs.
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, having 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 security of NHS prescription pads in the practice and ensure there are systems in place to monitor and track their use.