We carried out an announced comprehensive inspection on 4 October 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

Oasis Dental Care Central - Northampton 2 is a large dental practice in the centre of Northampton. It offers three distinct services to adults and children.

Firstly a general dental service which provides treatment either funded by the NHS or privately. This service sees patients for their ongoing oral needs and registers patients in this regard.

Secondly the practice offers and emergency NHS service from 8 am to 8 pm seven days a week, every day of the year. This is not a drop in service but can be accessed by calling the NHS 111 emergency telephone number. Patients are seen only as an emergency and would return to see their own dentist afterwards.

Thirdly the practice accepts referrals for minor oral surgery (MOS). Patients are referred for tooth extractions and other minor oral surgical procedures under local anaesthetic (with the patient awake).

The practice offers treatment under conscious sedation (these are techniques in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation) for nervous patients. The practice also offers dental implants, where a metal post or posts are placed surgically into the jaw bone and are used to support a single tooth, or multiple teeth.

The practice is staffed by seven dentists, an oral surgeon and two dental hygienists, supported by a head dental nurse, eight qualified dental nurses, three minor oral surgery nurses and four trainee dental nurses. Administration staff are a practice manager, a minor oral surgery manager, a practice co-ordinator, two administrators and three receptionists.

The practice is wheelchair accessible via the rear entrance of the building from the car park.

The practice manager 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.

Feedback about the service was obtained by speaking to patients that visited the practice on the day of our visit, and by comment cards that were left on the premises for the two weeks preceding our visit. Three patients provided feedback.

Our key findings were:

• The practice was visibly clean and clutter free.

• The practice met the national guidance in infection control standards.

• Patients reported that staff explained options to them, and dental care records detailed these discussions.

• Clinicians used nationally recognised guidance in the care and treatment of patients.

• There was appropriate equipment for staff to undertake their duties and equipment was well maintained.

• The practice carried medicines and equipment for use in a medical emergency in line with national guidance.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result.

• Review the practice's recruitment policy and procedures to ensure character references for new staff are requested and recorded suitably.

• Review the labelling of medicines that are dispensed giving due regard to schedule 26 of the Human Medicines Regulations 2012.
• Review the use of rectangular collimators on X-ray machines to further reduce the radiation dose to patients.

• Review the practice’s audit protocols of various aspects of the service, such as infection control to ensure they are completed at the appropriate intervals to help improve the quality of service. Practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.

We spoke with five people who had received treatment at the dental service and they all told us that they were happy with the level of treatment and care that they had been given. They also told us that they found it easy to access the dental service and that the reception staff did their best to find an appointment that best suited their requirements.

One person who was waiting for emergency treatment told us that they were impressed with the emergency appointment system because they had been able to make an appointment to see a dentist straight away. Another person told us that the reception staff were friendly and approachable and that they felt able to discuss any concerns they had about their treatment; either in person or by the telephone and know that these would be dealt with appropriately.

Most of the people we spoke with told us that the dentist had given them information about their treatment as well as any associated costs so that they could make an informed choice about the treatment that best suited their needs. They also told us that the dentist had given them information about how to look after their teeth in between appointments.

People we spoke also told us that they thought the treatment rooms were kept clean and tidy and that the dentists and dental nurses always wore gloves and masks before treating them.