We carried out an announced comprehensive inspection on 29 April 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

Steeple Grange Smiles is part of the Oasis Dental Care group of dental practices. The practice is located over two floors of premises close to the village of Wirksworth. The practice was first registered with the Care Quality Commission (CQC) in April 2011. The practice provides regulated dental services to both adults and children. The practice provides mostly private dental treatment (95%). There is a small NHS contract to provide services for minor oral surgery and orthodontics, and a service to a small number of children. Services provided include general dentistry, dental hygiene, crowns and bridges, root canal treatment and sedation.

The practice’s opening hours are: Monday: 8:30 am to 5:15 pm; Tuesday 8:45 am to 7:15 pm; Wednesday: 8:30 am to 7:15 pm; Thursday: 8:30 am to 5:15 pm; Friday 8 am to 5:15 pm and Saturday: by appointment one Saturday every month.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message, which directs the patient to a dentist. Alternatively patients could ring the Derby or Chesterfield emergency dental service.

The practice manager is registered with the Care Quality Commission (CQC) as an individual. 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 ten dentists; three dental hygienists; ten qualified dental nurses; two receptionists; a practice manager and one administrator primarily to deal with referrals.

We received positive feedback from 34 patients 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:

• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
• Dentists identified the treatment options, and discussed these with patients.
• Patients’ confidentiality was maintained.
• There were systems in place to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
• The practice carried out intravenous sedation for nervous patients or those requiring minor oral surgery.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• 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.

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

• Review the infection control arrangements in the minor oral surgery room with regard to the spittoon. Giving due regard to the guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05).

• Review the practice policy with regard to Equality and Diversity and consider installing a hearing loop as a reasonable addition as identified in the Equality Act (2010).

We spoke with three patients who had come for appointments at Steeplegrange Smiles. They were all private patients and were very happy with the treatment they had received. All of the patients told us they had been given the opportunity to ask questions about their treatment. One patient told us “I’ve been coming here for a number of years and I am very happy, the staff are very friendly”, another patient told us that the practice was regularly updating its equipment or refurbishing surgeries and that they were impressed by this.

We found that patients’ needs were assessed and that they were asked to complete a medical history questionnaire before being seen in the surgery. This information was then reviewed with the patients at subsequent visits. Patients’ records were stored securely and were held both electronically and on paper.

The three patients we spoke with advised us that they had never needed to make a complaint about their care. They told us that should they have any concerns, they would feel happy in discussing these with their dentist or the practice manager. The complaints records we looked at showed that the complaints received had been recorded and acted on appropriately.