We carried out an announced comprehensive inspection on 11 November 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

College Street Dental Practice is a converted domestic premises situated near the centre of the town with easy access to bus routes. It has four dentists; a visiting implantoligist and a part time hygienist service. There are four dental consulting rooms, an office, reception area and two waiting rooms. The premises had disabled access via the use of a ramp into the practice and facilities were accessible on the ground floor level. There was nearby on street parking and public car park.

The practice provides both private and NHS general dental services to children and adults and also provides an in house dental implant service from thevisiting implantoligist once a month; for those patients who require such treatment. The dental hygienist service is available on two days of the week.

Fees are displayed in information leaflets available in the practice for patients and on the website. The practice has a team of four dentists and a visiting dental implantologist, four dental nurses and two trainee dental nurses, a practice manager and three receptionists.

The practice 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.

The practice is open Monday 08.30am -7.00pm – Tuesday - Friday 08.30am – 5.00pm, Saturday 08.30am – 1.00pm. It is closed Sundays. The practice is closed alternate Saturdays and every Sunday but the out of hour’s emergency arrangements were displayed in the practice and were available via the practice telephone answering service.

The information was not available on the practice website but in discussion with the registered manager and provider we were told they would rectify this as soon as possible.

We reviewed 58 CQC comment cards that had been left for patients to complete prior to our visit. In addition we spoke with three patients on the day of our inspection. Feedback from patients was positive about the care they received from the practice.

They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided. Patients we spoke with and the comment cards reviewed told us staff were kind, caring, competent and put patients at their ease.

Our key findings were:

• The practice demonstrated they sought to provide patient centred dental care in a relaxed and friendly environment.
• There were systems in place to help ensure the safety of staff and patients. These included safeguarding children and adults from abuse and maintaining the required standards of infection prevention and control.
• Infection control procedures were robust and the practice followed published guidance.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The dental practice had effective clinical governance and risk management processes in place; including health and safety and the management of medical emergencies.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access urgent treatment and emergency care when required.
• The practice had a comprehensive system to monitor and continually improve the quality of the service; including through a detailed programme of clinical and non-clinical audits.
• The use of digital radiographs to help explain necessary treatment to patients while in the chair.
• Premises appeared well maintained and visibly clean. Good cleaning and infection control systems were in place. The treatment rooms were well organised and equipped, with good light and ventilation.
• There were systems in place to check all equipment had been serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.
• There were sufficient numbers of suitably qualified staff who maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines, supported in their professional development and the practice was led by a proactive registered manager.
• There was a process in place for reporting untoward incidents and disseminating shared learning when these occurred in the practice.