We carried out an announced comprehensive inspection of this practice on 29 June 2016. Breaches of legal requirements were found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to braches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) Regulation 17: Good governance. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to that requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bridgford Dental Practice on our website at www.cqc.org.uk

We carried out an announced follow up inspection on 16 March 2017 to ask the practice the following key questions; Are services well-led?

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Bridgford Dental Practice is a dental practice providing mostly private dental treatment. The practice is located in premises close to the centre of West Bridgeford on the outskirts of Nottingham. There is a small car park available to the front of the practice; otherwise there is pay and display or roadside parking in the area. The practice has three treatment rooms, all three of which are on the ground floor.

The practice provides regulated dental services to both adults and children. The practice provides mostly private dental treatment (70%). Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday to Friday: 9 am to 5 pm. The practice is closed for one hour for lunch.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Nottingham Emergency Dental Services offers an out-of-hours service.

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.

The practice has three dentists; one dental hygienist; three qualified dental nurses; one trainee dental nurse and a receptionist.

Our key findings were:

• All staff had received additional training in infection control procedures.
• Equipment used at the practice had been reviewed and where necessary replaced.
• New equipment had been purchased.
• The practice had introduced a system to deal with the issue of rusty instruments.
• Infection control procedures had been audited and a specialist review of the audit had been carried out.
• Record keeping had been improved to ensure a clear audit trail.

We carried out an announced comprehensive inspection on 29 June 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 not providing well-led care in accordance with the relevant regulations.

Background

Bridgeford Dental Practice is a dental practice providing mostly private dental treatment. The practice is located in premises close to the centre of West Bridgeford on the outskirts of Nottingham. There is a small car park available to the front of the practice; otherwise there is pay and display or roadside parking in the area. The practice has three treatment rooms, all three of which are on the ground floor.

The practice was first registered with the Care Quality Commission (CQC) in March 2013. The practice provides regulated dental services to both adults and children. The practice provides mostly private dental treatment (70%). Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice is a training practice for foundation dentists. These are newly qualified dentists who spend a year working in a practice under supervision to gain hands on experience.

The practice’s opening hours are – Monday to Friday: 9 am to 5 pm. The practice is closed for one hour for lunch.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Nottingham Emergency Dental Services offered an out-of-hours service.

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.

The practice has three dentists; one dental hygienist; three qualified dental nurses; one trainee dental nurse and a receptionist.

We received positive feedback from 51patients about the services provided. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

• 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.
• The practice was visibly clean and tidy.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Dentists identified the different treatment options, and discussed these with patients.
• Patients’ confidentiality was maintained.
• Patients said they had no difficulty getting an appointment that suited their needs.
• Patients we spoke with at the practice, and through CQC comment cards provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
• The practice was well equipped and provided a relaxed atmosphere for patients.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• Patients were able to express their views and comments, and the practice listened to those views and acted upon them.

We identified regulations that were not being met and the provider must:

• Ensure an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.

• Ensure the practice’s infection control procedures and protocols are suitable giving due regard to 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’.

You can see full details of the regulations not being met at the end of this report.

We spoke with one patient and observed four others during our visit. We looked at information and records at the practice.

We found patients were complimentary about the staff and there was a relaxed atmosphere throughout the practice.

Staff welcomed patients in a polite and respectful manner. Patient’s told us they were satisfied with the service provided and they were involved in all aspects of their treatment.

Patients said the dentist listened to what they had to say and discussed all options that were available.

We saw good information about the practice and patients told us they received enough information to make informed choices. There was appropriate reading material available for patients to read or take away.

We saw the practice offered different payment plans and patients told us they were aware of the cost regarding each option.

We found the practice to be clean, tidy and well maintained. Patients we spoke with felt the practice was fit for purpose.

We found the reception was small and compact with seating for ten persons. There was access available for people with disabilities and the surgeries were on the ground floor.