We carried out an announced comprehensive inspection on 2 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 providing well-led care in accordance with the relevant regulations.

Background

Oasis Dental Care Central – Pershore is in Pershore town centre and mainly provides NHS dental treatment. It is the only dental practice in the town. Private treatment is available if patients request this. The practice has four dentists, a dental hygienist, one dental nurse and two trainee dental nurses (one of whom is about to qualify). The clinical team are supported by two reception staff and a practice manager. The practice manager joined the practice at the start of 2016 and is also a dental nurse and the registered manager. Like registered providers, registered managers 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 four dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments. There is level access into the reception, main waiting area and three treatment rooms. There is a slight change of level on the ground floor which the practice has addressed by ramping the floor in preference to steps. We saw signs on the walls to alert patients to this. The patient toilet is equipped for patients with physical disabilities. There are two steps up to one treatment room and the staff areas.

The practice is open from 8am to 8pm Mondays,Tuesdays and Wednesdays, 8am to 7pm on Thursdays and 8am to 5pm on Fridays.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could tell us about their experience of the practice. We collected 17 completed cards and also saw the most recent Oasis, NHS Friends and Family and NHS dental services survey results. This information showed that patients are positive about the practice and appreciative of the service it provides. Patients described the practice team as polite, helpful, and caring. Several used words such as exceptional and considerate and commented that they received detailed explanations of the treatment they needed in a way they understood. The most up to date cumulative Oasis results showed that 97% of patients said the quality of their treatment was good, 98% would recommend the practice to others and 94% felt involved in decisions about their care. The NHS dental services survey and Friends and Family results were similarly positive.

Our key findings were:

• The practice was visibly clean and some patients specifically mentioned this. The practice had systems to assess and manage infection prevention and control.

• The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.

• The practice had clear processes for dealing with medical emergencies and for ensuring that dental equipment was regularly maintained. There were some indications that the practice may not have sufficient instruments

• Dental care records provided clear and detailed information about patients’ care and treatment.
• Staff received training appropriate to their roles and were supported in their continued professional development.

• Patients were able to make routine and emergency appointments when needed.

• The practice had established a variety of ways to gather patients’ views including in-house surveys and the NHS Friends and Family test.

• Patients said they received service they felt met their needs and were treated with respect.

• The practice had governance processes in place to manage the service provided.

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

• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice protocols and adopt an individual risk based approach to patient recalls giving due regard to National Institute for Health and Care Excellence (NICE) guidelines.
• Review the availability of sufficient quantities of instruments within the practice.
• Review dental nurse staffing levels at the practice taking into account the extended hours service provided and the practice’s current recruitment challenges.

As part of our inspection we spoke with four people who were registered with the practice. We also spoke with the dentist, the practice manager and the dental nurse. We reviewed six dental records, looked at three staff files, policies and procedures and the quality assurance records.

People who used the practice told us that they were happy with the quality of treatment they received. They felt they were given enough information about their treatment options and were able to ask any questions that they wanted to.

People told us that the practice was clean and tidy and that they had no concerns about hygiene. The staff told us that regular infection control checks ensured that hygiene and cleanliness was maintained in clinical areas.

By looking through the staff records we were able to see that the dentists and staff were qualified and maintained their continuous professional development (CPD) as required by the General Dental Council (GDC).

Staff told us they felt they were supported by their managers through regular staff meetings and supervisions. The staff said that this helped them make sure their training and development needs were identified and addressed.

People were able to provide regular feedback and we saw evidence of actions being implemented from this. We saw that there were regular audits and quality checks.