We carried out an announced comprehensive inspection on 3 March 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 providing well-led care in accordance with the relevant regulations.

Background

Broadbank Dental is a single handed private dental practice in the market town of Louth. The practice is situated close to the town centre with its own car park. The practice is in a building that has been adapted for the purpose of dentistry and has a reception area with a wheelchair friendly desk and two treatment rooms. There is a separate waiting room with high back chairs and chairs with arm rests to enable ease of use for those with limited mobility. There are two treatment rooms (one the ground floor), a decontamination room, a public toilet, staff toilet, an office and a staff room. The practice has plans to expand into the car park area subject to local council approval. The building is accessed from the street and there are four steps up to the main entrance. For those patients with limited mobility, wheelchair access, or pushchairs access to the practice is via the rear entrance through the car park and a portable ramp would be used.

There is one dentist that currently works full time alongside one full time hygienist, a part time hygienist, three part time dental nurses and two part time reception staff.

The dentist is the owner and registered manager of the practice. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered dentists, 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 provides private dental treatment to adults and children. The practice is open Monday to Friday from 9am and closes at 5.30pm other than Wednesday when it closes at 5pm and Friday when it closes at 4pm.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 50 patients about the services provided. The feedback reflected highly positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy and that it was caring and friendly. They said that they found the staff offered an efficient and professional service and had high confidence in the team. They said that staff were polite, helpful and obliging. Patients said that explanations about their treatment were clear and that they were given time and all options were fully explained. Much of the feedback was in relation to patients who were nervous and they commented how the staff were understanding and patient; they were made to feel at ease and that any questions were answered.

Our key findings were:

• There was a process in place for reporting and learning from incidents, accidents and near misses.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in place and staff had access to personal protective equipment.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks.
• Patients were treated with dignity, respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies.
• Governance systems were effective and policies and procedures were in place to provide and manage the service.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities.

There were areas where the dentist 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 ensure a Disability Discrimination Act audit is undertaken for the premises.
• Review the frequency of  testing of fire detection and fire fighting equipment.

People we spoke with told us they felt fully informed about and were also able to ask questions about the treatment they received. One person said, “The dentist is wonderful, they explain everything to me. I am always told what charges there are and he prints out a document with a full description of what treatment is needed.”

Members of staff we spoke with told us they had received training about medical emergencies and also received regular updates. We saw staff training records confirming this.

People we spoke with all told us that they thought that the premises and treatment rooms were clean. One person said, “I’ve been coming here for years, the atmosphere in the waiting room is very pleasant, not too clinical. The whole place is spotless, much cleaner than anywhere else I have ever been.”

We noted that the practice had a separate decontamination room for cleaning and sterilising instruments. We also met with a member of staff who worked in this area and carried out this work.

We saw the practice's current complaints procedure, which was displayed in the waiting room. We were told by the practice manager, how they would work with the patient to resolve their complaint within 10 days of receipt.