We carried out an announced comprehensive inspection on 16 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

Oasis Dental Care - Lincoln 1 is a dental practice situated in the heart of Lincoln city centre. The practice is part of Oasis Dental Care Limited. The practice is in a building that has been adapted for the purpose of dentistry and is situated over two floors. Part of the practice is a Grade two listed building and the upstairs waiting area retains many of the buildings original features. On the ground floor there is a treatment room, reception desk with a waiting area, a small office area at the back of the reception and two patient toilets, one of which has been adapted for the needs of disabled or patients with limited mobility. The first floor has three treatment rooms, a waiting area, a decontamination room, a small staff kitchen area, staff changing room and staff toilet. Both waiting areas have high back chairs and chairs with arm rests to enable ease of use for those with limited mobility. The entrance to the practice is from the street and can be easily accessed by those patients with limited mobility, wheelchair access, or pushchairs. There is an intercom at the front door so that patients can alert staff of their arrival if they are unable to open the door.

There are seven dentists working in the practice alongside two hygienists, four dental nurses and four trainee dental nurses. There are also two reception staff and a practice manager. One of the dental nurses also works covering reception duties and the practice manager is also a qualified dental nurse.

The practice manager is the 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 NHS and some private dental treatment to adults and children. The practice is open Monday to Thursday from 7am to 7pm, Friday 7am to 5.30pm and Saturday morning from 8.30am to 12pm.

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 42 patients about the services provided. The feedback reflected mainly 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 a welcoming and professional service and had high confidence in the team. They said that staff were polite, helpful and kind. Patients said that explanations about their treatment were clear. Feedback in relation to patients who were nervous 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 appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• 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.
• The practice had the necessary equipment to deal with medical emergencies, and staff had been trained how to use that equipment. This included oxygen and emergency medicines.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Policies and procedures at the practice were kept under review.
• Dentists involved patients in discussions about the care and treatment on offer at the practice. Patient recall intervals were in line with National Institute for Health and Care Excellence (NICE) guidance.
• 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; staff felt involved and worked as a team.
• 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 was a process in place for reporting and learning from significant events and accidents, however this did not include near misses and incidents.

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 practice’s system for the recording, investigating and reviewing incidents with a view to preventing further occurrences and, ensuring that improvements are made as a result.
• Review the practice whistleblowing policy to give staff the option of contacts outside of the organisation and practice such as the Care Quality Commission (CQC) or General Dental Council (GDC).

Oasis Dental Care Lincoln is a large practice arranged over two floors. We observed there was a welcoming reception area, with lots of reading material and information leaflets for patients to read. There was large waiting room upstairs: again this had information for patients and reading material for children. The environment was clean and well maintained.

We reviewed the arrangements for obtaining consent to treatment, and found there were appropriate procedures in place. We looked at treatment plans for a sample of people who used the service. These contained a summary of the examination, treatment options and cost. People told us that “the staff were wonderful and always put the patients first”.

We checked the records relating to the maintenance of equipment that was being used at the practice. We found that this had been regularly maintained and serviced.

We checked the infection control measures at the practice and found that appropriate audits, cleaning and infection control measures were in place. We reviewed the "complaints" policy and procedure and noted that complaints were investigated and outcomes recorded in accordance with the complaints policy.

Patients told us they received the treatment they wanted in an efficient and organised way. They said they were involved in decision making about their treatment and were able to express their views about the service provided.

Patients said they always found the environment to be clean and tidy. They told us staff wore the right protective equipment when treating them, such as uniforms, gloves and masks. They also said they were offered protective glasses and clothes protection during their treatment.