We carried out an announced comprehensive inspection on 28 February 2017 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

Calverton Dental Practice is located in premises situated in the village of Calverton to the north of the city of Nottingham. There are two treatment rooms both of which are situated on the first floor. Access for patients with restricted mobility is by a chair lift. The practice provides mostly NHS dental treatments (95%) There is a small car park for dental patients close to the practice.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours were – Monday: 9 am to 3:30 pm; Tuesday: 9 am to 5 pm; Wednesday: 9 am to 5 pm; Thursday: 9 am to 3 pm and Friday: 9 am to 3 pm. The practice is closed at the weekends.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number direct. An NHS out-of-hours dentistry service also operates in Nottingham.

The practice has two dentists; two hygienists; one qualified dental nurse who also works on reception and two trainee dental nurses.

The principal dentist 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.

Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from 24 patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides. Among the themes we identified from patient feedback were: patients were listened to and involved in discussions about treatment options; the practice was clean and hygienic; staff were caring; staff were responsive and friendly.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• The systems to record accidents, significant events, complaints and the resulting learning points were recorded and used to make improvements.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• The practice held information related to the Control of Substances Hazardous to Health (COSHH) Regulations 2002. This included risk assessments. However, this information was not well ordered which would make finding information in a hurry difficult.
• The practice had a consent policy including reference to the Mental Capacity Act 2005.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect and were able to get an appointment that suited their needs.
• Dental care records demonstrated that the dentists involved patients in discussions about treatment options.
• Patients’ confidentiality was protected within the practice.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• Many of the policies at the practice were not dated which made it difficult to assess if and when they had last been reviewed.
• 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 about a colleague’s practice.
• 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, medical oxygen and emergency medicines.

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

• Review how information is stored in the Control of Substances Hazardous to Health (COSHH) file so that information is more easily accessible in an emergency situation.

• Review the frequency that policies and procedures are reviewed and record a date to indicate when the review has been completed and the next one due.