We carried out an announced comprehensive inspection on 31 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

Clock Tower Dental practice is located close to the centre of Ripon, North Yorkshire. They provide private care and treatment for adults and National Health Service (NHS) care and treatment for children. The five treatment rooms are arranged over three floors, two waiting rooms, a reception area, two offices, a decontamination room, patient toilets and staff facilities and a separate room for the Orthopantomogram (OPT) machine (an OPT machine is a panoramic scanning dental X-ray of the upper and lower jaw).

There are six dentists (the clinical director and five associates), three dental hygienists, six dental nurses (two of which are trainees), a decontamination nurse, a receptionist, a business manager and a practice manager.

The practice offers private treatments including preventative advice, periodontal treatment and advanced restorative treatment. There is also laser treatment, endodontic treatments, implants, inhalation sedation and intravenous sedation and orthodontic treatments available.

The practice is open:

Monday- Friday 08:30 – 17:30.

The business manager 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.

On the day of inspection we received five CQC comment cards providing feedback and spoke with 17 patients. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be caring and careful to explain treatment options. Patients also told us they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• There was a complaints system in place. Staff recorded complaints and cascaded learning to staff.
• The governance systems were effective.
• The practice sought feedback from staff and patients about the services.

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

• Implement an effective stock rotation and management system to ensure all dental materials are in date.
• Review the practice’s protocol for undertaking audits of dental care records at regular intervals to help improve the quality of service. The practice should also ensure all audits have documented learning points so the resulting improvements can be demonstrated.
• Review the practice’s protocols for conscious sedation, giving due regard to 2015 guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015’.
• Review the practice’s protocols and procedures for promoting the maintenance of good oral health giving due regard to guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’.
• Review and place an accessible complaints policy in the patient waiting areas.

To help us understand the experiences of people using the service, we spoke with people who had attended the surgery at the time of our inspection.

We spoke with five people in private at the practice address. Everyone we spoke with said that they were treated with respect. They said they signed to say they agreed with the treatment and had their treatment options explained to them. People told us they were supported to make decisions and choices regarding their care and treatment. One person said “The dentist I have is very thorough and he has a good reputation.” Another told us “I would recommend this practice with no hesitation.”

People told us they did not have to wait too long for appointments and that they were always welcomed in a friendly manner. One person said “I cancelled my appointment last week and was able to re-arrange another one within two days.” Another person said “I only phoned them late yesterday afternoon with an emergency, as I was away from home, but was able to get an appointment for today.”

People commented that they thought the surgery and practice building were clean. One person said “The practice is always spotless.”

People told us that they would speak to the dentist or the practice manager if they needed to complain. One person commented “I have never had to make a complaint, but if I did I would speak to the practice manager.”