We carried out an announced comprehensive inspection on 1 March 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

Bramley Dental Practice Annexe - Cross Street is located in Bramley, Rotherham and provides NHS and private treatments to adults and children, which includes dental implants and cosmetic dentistry. The practice is a foundation dentist training practice. The annex is a separate location from the main practice 25 yds away on the main street of Bramley. Access to the practice is via one flight of stairs and car parking is available nearby.

The dental team is comprised of eight dentists (one is a foundation training dentist), eight dental nurses (five are trainee dental nurses), one dental hygienist, one dental hygiene therapist, two practice managers and three receptionists. There are two treatment rooms and an instrument decontamination room. There is a reception/waiting area with separate staff and patient toilet facilities and a small office.

On the day of inspection we received 32 CQC comment cards providing positive feedback.

The practice is open: Monday and Tuesday 9:15am - 6:00pm, Wednesday to Thursday 9:15am - 5:00pm. Friday 9:00am - 1:00pm

There is no current member of staff registered as a manager at this practice. 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 saw evidence which confirmed that registration was in progress.

Our key findings were:

• The practice appeared visibly clean and tidy.
• The practice had systems in place to assess and manage risk to patients and staff but some processes required improvement.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• Emergency equipment was in place and staff were trained to respond to medical emergencies.
• Staff understood and received safeguarding training and knew how to recognise signs of abuse and how to report it.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Safe recruitment of staff was in place.
• Treatment was well planned and provided in line with current guidelines.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• The practice was well-led, staff felt involved and supported and worked well as a team.
• The governance systems were effective and embedded.
• The practice sought feedback from staff and patients about the services they provided.
• Complaints were responded to in an efficient and responsive manor.

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

• Review the security of prescription pads and ensure there are systems in place to monitor and track their use.
• Review the process for assessing X-ray quality to ensure they are in line with the National Radiological Protection Board and IR(ME)R 2000 regulations.
• Review the practice’s process for the tracking of external referrals.
• Review staff knowledge of the Mental Capacity Act and Gillick competency.
• Review the practice’s latex procedures and implement a policy to assess safety to staff and patients.

People's needs were assessed and treatment was planned and delivered in line with their individual treatment plan. The people we spoke with commented positively about the care and treatment they had received. One person told us “I have had lots of treatment here and they have all been good experiences.”

There were effective systems in place to reduce the risk and spread of infection. We saw people were protected from the risk of infection because appropriate guidance had been followed. People we spoke with told us the practice was clean and staff always wore protective clothing when treating them.

There were enough qualified, skilled and experienced staff to meet people's needs. During our inspection we saw staff were able to meet people's needs in a timely way.

Staff received appropriate professional development. We saw staff had accessed various training so they could meet people’s needs and maintain their qualifications. People told us staff seemed well trained and competent in their jobs.

The practice had an effective well organised system to regularly assess and monitor the quality of service that people received.