We carried out an announced comprehensive inspection on 21 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

Bramley Dental Practice 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.

Access for wheelchair users and pushchairs is via a portable ramp into the reception area. Car parking spaces are available near the practice.

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 five treatment rooms and an unused X-ray room. The practice has been extended over the years and has a separate annex building approximately 25yds away, in which are two further treatment rooms and the instrument decontamination room.

On the day of inspection we received 25 CQC comment cards providing positive feedback and we spoke with four patients.

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 clean but was cluttered due to space limitations.
• Infection control procedures were effective but the process for the transportation of contaminated instruments required improvement.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice had systems in place to manage risk but some processes required improvement.
• 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.
• Emergency equipment was in place and staff were trained to respond to medical emergencies.
• 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 required improvement.
• The practice sought feedback from staff and patients about the services they provided but could be improved.
• Complaints were responded to in an efficient and responsive manor.

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

• Review the practice’s Reporting of Injuries, Disease and Dangerous Occurrences Regulations 2013 (RIDDOR) policy and embed it within the practice to bring it in line with current regulations.
• Review the security and storage of dental care records to comply with the Data Protection Act.
• Review the current fire assessment and complete the actions identified to mitigate the escape risk and embed fire safety within the practice.
• 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 and provide refresher training.

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. They said it was easy to make appointments and waiting times at the practice were minimal. One person told us “My dentist gives me all the options available and talks me through the process with me.”

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.