We carried out an announced comprehensive inspection on 13 March 2017 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

Cromwell Dental Practice Limited is situated in Grimsby, Lincolnshire. The practice provides dental treatment to adults and children on an NHS or privately funded basis. The services include preventative advice and treatment and routine restorative dental care.

The practice is situated in a medical centre and has four surgeries, a decontamination room, a waiting area and a reception area. All of the facilities are on the ground floor of the premises along with accessible toilet facilities.

There are four dentists, one dental hygiene therapist, five dental nurses, two receptionists and a practice manager. On the day of inspection the practice manager was not able to attend.

The opening hours are Monday, Thursday and Friday from 8:30am to 5:30pm, Tuesday from 8:30am to 6:30pm and Wednesday from 8:30am to 5:00pm.

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.

During the inspection we received feedback from seven patients. The patients were positive about the care and treatment they received at the practice. Comments included staff were caring, attentive and helpful. They also commented they were able to make appointments which suited their needs and the premises were clean and tidy.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• The system for identifying significant events and disseminating information required improvement.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed patients were treated with kindness and respect by staff.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• There were clearly defined leadership roles and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

• Review the practice’s system for recording and disseminating information from incidents or significant events.
• 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
• Review the process for checking Hepatitis B immunisation status at the point of employment.
• Review the practice’s process for acting on recommendation from routine tests of the X-ray machines.
• Review the frequency of staff meetings and they availability of meeting minutes.

We found people were provided with a wide range of information about the service and the treatment they were offered. People who used the service told us that dentists had taken their individual needs into account when providing care and treatment. We found that the environment and written information available was not particularly child friendly. For example, the reception area had a very limited selection of toys and books and all the information on display was aimed at adults.

We found that the provider had procedures in place to safeguard both children and vulnerable adults and staff were aware of their role in safeguarding these groups.

We found that the provider had robust procedures in place to minimise the risk of cross infection.