We carried out an unannounced comprehensive inspection on 21 June 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

Crankhall Lane Dental Practice provides general dental services on a NHS (predominantly) basis. Some private treatment is also offered. The service is provided by two dentists. They are supported by five dental nurses (one of whom is a trainee) and a practice manager. The practice manager is also a qualified dental nurse. All of the dental nurses (apart from the trainee) also carry out reception duties.

The practice is located on a main road adjacent to other commercial properties. There is wheelchair access to the practice and nearby car parking facilities. The premises consist of a waiting room, one treatment room and a reception area on the ground floor. The first floor comprises of two treatment rooms, a spare room and toilet facilities. One of the treatment rooms was no longer used. Opening hours are from 9am to 6pm on Mondays and Thursdays, 9am to 5:30pm on Tuesdays and Wednesdays and 9am to 5pm on Fridays.

The provider is registered with the Care Quality Commission (CQC) as an individual. 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.

Four patients provided feedback about the practice. Feedback from patients was overwhelmingly complimentary. Patients were positive about their experience and they commented that staff were friendly, caring and polite.

Our key findings were:

• The practice appeared clean and tidy on the day of our visit. All patients we spoke with commented that this was their experience.

• Feedback from patients described the service as friendly, kind and caring. Patients were able to make routine and emergency appointments when needed.

• The practice carried out effective infection control procedures in line with current guidance.

• The practice had systems to monitor and manage risks to patients, staff and visitors. This included infection prevention and control, health and safety, safeguarding, safe staff recruitment and the management of medical emergencies.

• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.

• Staff received training appropriate to their roles.

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.

• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.

• The practice had a comprehensive schedule of clinical audit demonstrating their commitment to continuous improvement.

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

• Review stocks of medicines and the system for identifying and disposing of expired stock.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society
• Consider installing rectangular collimators to their X-ray equipment to reduce radiation doses.
• Review the practice’s protocols for recording in the patients’ dental care records details of X-ray reports and consent.

During our inspection we spoke with one dentist, two dental nurses, the practice manager and a reception staff. We looked at the records for seven people who had used the service.

Following our visit we spoke with four people over the telephone so that we could get their views of the quality of service provided. All the people we spoke with were happy with the treatment provided by the surgery and made various positive comments about the service. One person said: “It’s been absolutely excellent, ten out of ten”. Another person said: “Brilliant”. We found that patients were given information about their treatment options and the costs of treatment.

People were asked to complete a health questionnaire and were asked about any changes at subsequent visits. There were regular checks to ensure equipment’s and emergency medications were in working order.

The practice had appropriate infection control systems and procedures in place.

Equipment was appropriately tested and serviced.

Staff had received appropriate training and development to enable them to deliver treatment to people safely and to an appropriate standard.

There were procedures in place to monitor quality of service and identify improvements where necessary. Appropriate systems were in place to manage any complaints and to seek feedback from patients about their experience.