We carried out an announced comprehensive inspection on 13 October 2015 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

Brookfield Dental Care is located in Rushden, Northamptonshire and treats both NHS and private dental patients, with the majority being private patients (approximately 90%). The practice has three dentists. two dental therapists, a hygienist, a practice manager and five additional dental care professionals (DCP).

The practice is situated in a converted house with a car park at the rear of the practice and provides services from the ground floor only and is wheelchair accessible.

The practice opening hours are Monday and Friday 8.30am to 5pm with late opening on Tuesday, Wednesday and Thursday until 6pm.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We viewed 45 comment cards that had been completed by patients about the services provided. All cards reported positive comments with the exception of one regarding charges. Patients’ comments reported experiencing an excellent service, and highlighted the friendliness and professionalism of the staff and that the dentists made patients feel relaxed and comfortable. We also spoke with four patients during the inspection who all told us that they had received an excellent service and felt well cared for by all staff.

Our key findings were:

• The practice had a system for recording significant events and complaints and staff knew how to follow the process if there was an event or a complaint received.
• All staff had received safeguarding vulnerable adults and children, and whistle blowing training and knew what to do and how to raise any concerns.
• The practice was clean and well maintained.
• There were sufficient numbers of suitably qualified and experienced staff to meet the needs of patients.
• Staff had been trained to deal with emergencies, although they had not carried out regular scenario practice as recommended by Resuscitation Council.
• There were appropriate medicines and life-saving equipment available.
• The practice had infection control procedures which were in line with national guidance.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, good practice and current legislation with the exception of rubber dams which were not routinely used.
• Patients received explanations about their proposed treatment, costs, options and risks and were involved in making decisions.
• Patients were treated with dignity and respect and their confidentiality was maintained.
• The practice was well-led and staff worked as a team.
• Governance systems were effective and the practice completed a range of clinical and non-clinical audits to monitor the quality of services. However, we did not always see evidence of action taken as a result, for example, testing water temperatures at sentinel points.
• The practice sought feedback from staff and patients about the services they provided.

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

• Review their practice in relation to endodontic procedures with particular reference to the use of rubber dam in line with British & European Endodontic Society guidelines.
• Require all clinicians to carry out radiograph audit on an annual basis with results, action sheets if appropriate and completion sheets populated.
• Introduce checking procedures and recording for testing water temperatures at sentinel points and ensure this is performed regularly in line with the recommendations of their own agency report
• Carry out regular performance appraisals with the practice manager.
• Review standards, guidelines and regulations to ensure all staff are aware.
• Rationalise the filing system for radiation protection.