We carried out an announced comprehensive inspection on 24 May 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

Clover House Dental Practice is a private dental practice which offers dental payment plans. The practice is located in the centre of Harrogate, North Yorkshire with on street car parking close by and a small car park located at the front of the building. The practice has four treatment rooms over two floors, a reception area, two waiting areas (one on each floor) a decontamination room, a laboratory casting room and staff facilities. .

There is a permanent ramp at the front entrance and the practice doors have been widened to accommodate wheelchairs. There are four dentists (two are the principal dentists and two associates), five dental hygienists, six dental nurses, a treatment co-ordinator and two receptionists.

The practice offers private dental treatments including preventative advice, routine restorative dental care, simple orthodontic treatments and same day crowns.

The practice is open:

Monday – Friday 08:45 – 13:00 & 14:00 – 18:00 and a late night on a Tuesday till 20:00.

The one of the principal dentists 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 26 CQC comment cards providing feedback and spoke to four 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 very involved in all aspects of their care and discussions of treatment. They found the staff to have a commitment to prevention, be professional, courteous, respectful, and friendly and 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.
• Infection control procedures were in accordance with the published guidelines.
• The practice had a system in place for recording accidents and adverse incidents.
• 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 and were actively involved in making decisions about it. They were treated in a way that they liked by staff.
• 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.
• The appointment system met the needs of the patients and waiting times were kept to a minimum. Emergency slots were available each day for patients requiring urgent treatment.
• 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 they provided and used these to help them improve.

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

• 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.

Before people received any care or treatment they were asked for their consent. We spoke with four people on the day of our inspection and they told us that they felt fully involved in discussions regarding their treatment and were given a range of options to consider before deciding what treatment to have.

During our inspection we asked people visiting the dental practice what their experience was like. Comments included “Fantastic”, “I have every confidence, they have taken away my fear” and “I rang this morning with some pain and they have seen me straight away.”

We asked people if they thought the dental practice was clean. They told us they had no concerns regarding the cleanliness or hygiene at the practice. One person described it as “Spotless.” Appropriate arrangements were in place for the sterilization of equipment. This ensured that effective systems were in place to reduce the risk and spread of infection.

Staff received appropriate professional development. Patients told us they felt staff were extremely knowledgeable.

People who used the service, their representatives and staff were asked for their views about their experience at the practice. We were told by staff that following treatment, which was anything beyond a routine check up, that each patient was called by the practice the following day to ask them if everything was ok and if they had any concerns. Patients confirmed this.