We carried out an announced comprehensive inspection on 3 February 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

Cabourne Dental Practice opened in 1993 in a purpose built practice alongside other health services such as two GP practices, a physiotherapist and a pharmacy. The practice is a now a private practice and has approximately 1800 registered patients. The practice has a small reception area that is in the waiting room. The practice consists of three treatment rooms (two in use, the third is used as a room to discuss treatment or for any other confidential conversations), a decontamination room and an office which is also the staff room. There is free parking available in a large car park that is shared with the other buildings. The building is accessed from the car park and once in the practice all areas are accessible to people who use wheelchairs.

There is one dentist that works full time alongside two full time dental nurses, one part time dental nurse and the practice manager. The dental nurses have dual roles and also work on reception.

The practice provides private dental treatment to adults and to children. The practice is open Monday to Thursday from 8am to 4pm.

The owner and provider 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.

We received feedback from 47 patients about the services provided. The feedback reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy and had a welcoming atmosphere. They said that they found the staff offered a friendly, professional and efficient service and were polite, helpful and caring. Patients said that explanations about their treatment were clear and that they were always informed of what was happening which made the dental experience as comfortable as possible. Patients who were nervous commented how the dentist was understanding and patient; they were made to feel at ease and that any questions were answered.

Our key findings were:

• 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.
• 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 and 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 and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies and appropriate medicines and life-saving equipment were readily available and accessible
• Governance systems were effective and policies and procedures were in place to provide and manage the service.
• Staff had received formal safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities with a structured chart to refer to.
• The practice had a whistleblowing policy in place which gave staff the option of contacting a neighbouring practice manager if they had any concerns that they wished to discuss.

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

• Review published guidance (HTM 01-05) in relation to hand washing.
• Review the British National Formulary (BNF) guidance for medical emergencies in dental practice and the recommended equipment.
• Review Public Health England document: ‘Delivering better oral health: an evidence based toolkit for prevention’.

We reviewed the provider’s client satisfaction survey results and noted that the results were positive about the practice. This and the other evidence reviewed showed us that people’s privacy, dignity and independence were respected by this practice.

We reviewed seven dental treatment records and these were completed in full and included all the required information to enable people to receive safe and appropriate dental care. This demonstrated to us that each person's dental care and treatment was planned and delivered appropriately.

Staff spoken with understood their responsibilities around safeguarding and told us that they were confident that they would recognise and know what action to take if they observed any potential abuse. This showed us that people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

The practice was clean and well maintained. We saw that the required systems and processes were in place to decontaminate the re-usable dental equipment used by the practice. This showed us that people were cared for in a clean and hygienic environment.

Those treatment records seen demonstrated that individual dental treatments were reviewed upon each appointment and discussed with the patient. This showed us that the provider had an effective system to monitor the quality of the services being provided.

Patients told us they received the treatment they wanted in an efficient and organised way. One patient told us, “I have total confidence with the dentist and the staff.” Patients 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.