We carried out an announced comprehensive inspection on 24 January 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

Breaston Dental Care is located in premises situated in the village of Breaston just outside Long Eaton. There are three treatment rooms one of which is situated on the ground floor. The practice provides mostly NHS dental treatments (75%). There is a free time limited car park for dental patients outside the practice.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday: 8:30 am to 5 pm; Tuesday: 8:30 am to 8 pm; Wednesday: 8:30 am to 5 pm; Thursday: 8:30 am to 5 pm and Friday 8:30 am to 4 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number. An NHS out-of-hours dentistry service also operates in Derby.

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

The practice has three dentists; one hygienist/ therapist; five qualified dental nurses; including one practice manager. Dental nurses also worked on the reception desk.

Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from eight patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• The systems to record accidents, significant events and complaints, learning points from these were recorded and used to make improvements.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• There were effective systems at the practice related to the Control of Substances Hazardous to Health (COSHH) Regulations 2002.
• The practice had a robust consent policy including reference to the Mental Capacity Act 2005.

• Patients were able to access emergency treatment when they were in pain.

• Patients provided positive feedback about their experiences at the practice. They told us they were treated with dignity and respect and had no problem getting an appointment to suit their needs.

• Dental care records demonstrated that the dentists involved patients in discussions about treatment options.
• Patients’ confidentiality was protected within the practice.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.

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

Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and consider installing a hearing induction loop to assist patients and visitors who used a hearing aid.

We spoke to four people using the service who were all very happy with the care and treatment they received. None of the people we spoke to had any concerns about the cleanliness of the practice and they told us the staff were very polite and helpful.

All of the people using the service reported that they had felt well informed about their course of treatment and that the practice was run well. One patient stated “it’s the best one (dentist) I’ve ever been too”.

One patient told us “They are absolutely brilliant from reception staff to the dentist. It’s the first time I have been able to go in (to a dentist) by myself as I was terrified”.