We carried out an announced comprehensive inspection on 21 October 2015 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

The practice is close to the centre of Skegness in Lincolnshire. It is a modern surgery with a central decontamination suite, and a spacious patient waiting room with children's play area. At the rear of the practice is a free car park. There are ground floor surgeries for easy access and provide disabled parking spaces at the front of the building.

There are four dentists, and seven dental nurses, four of whom are also radiographers. There are also two hygenists/dental therapists and a practice manager and deputy practice manager.

The practice provides private dental treatment services to both adults and to children. The practice is open Monday to Friday from 8.30am to 5.30pm other than Friday when the practice closes at 5.00pm. Saturday is by appointment only.

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.

We viewed 17 CQC comment cards that had been left for patients to complete, prior to our visit and spoke with three patients about the services provided. All of the comment cards reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy, they found the staff very friendly and efficient and they found the quality of the dentistry to be excellent. They said explanations were clear and made the dental experience as comfortable as possible

The practice was providing care which was safe, effective, caring, responsive and well-led in accordance with the relevant regulations.

Our key findings were:

• The practice recorded and analysed significant events and complaints and cascaded learning to staff.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and appropriate medicines and life-saving equipment were readily available and accessible.
• 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 and were involved in making decisions about them.
• 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.
• There was an effective complaints system.
• The practice was well-led and staff felt involved and worked as a team.
• Governance systems were effective however clinical and non-clinical audits could have been used more to monitor the quality of services.

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

• Re-site sharps bins so they are out of the reach of small children
• Use the bowl for rinsing in the decontamination process
• Ensure audits of various aspects of the service, such as radiography and dental care records are undertaken at regular intervals to help improve the quality of service. Practice should also ensure all audits have documented learning points and the resulting improvements can be demonstrated.
• 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.
• Risk assessment to complete in relation to lack of coved flooring in three surgeries.

People we spoke with told us they felt fully informed about and were also able to ask questions about the treatment they received. One person said, "The dentist explained all the different options and their benefits and the decision was mine. I am always told the price and given options.”

Members of staff we spoke with told us they had received training about medical emergencies and also received regular updates. We saw staff training records confirming this.

People we spoke with all told us that they thought that the premises and treatment rooms were clean.

We noted that the practice had a separate decontamination room for cleaning and sterilising instruments. We also met with a member of staff dedicated to working in this area and carrying out this work.

We saw the practice's current complaints procedure, which was displayed in the waiting room. We were told by the practice manager, how they would work with the patient to resolve their complaint within 10 days of receipt.