We carried out this announced inspection on 18 December 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide information of any concern.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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

Denaby Dental Practice is in Doncaster and provides NHS and private treatment to adults and children.

There is ramp access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes three dentists (two of whom are specialists in oral surgery), three dental nurses and a practice manager/dental nurse. The practice has two treatment rooms and an instrument decontamination room.

The practice is owned by an individual who is the principal dentist there. They 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 collected 46 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, three dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday, Thursday and Friday 9am – 5pm

Wednesday 9am – 12:30pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines; we identified an area where some improvements could be made.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

There were areas where the provider could make improvements. They should:

• Review the practice’s fire safety management processes and ensure all routine fire safety checks are recorded.
• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s processes for taking routine X-rays to ensure they are taken at recommended intervals in accordance with current guidance.

Patients who used the service understood the care and treatment choices available to them. One patient told us "I always know what’s happening with my treatment."

Patient’s needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. All the patients we spoke with who used the service told us that they gave a full medical history when they joined the dental practice and were regularly asked for updates. One patient said, "I get a wonderful service here." Another patient said “I get a great personalised service.”

Patients were protected from the risk of infection because appropriate guidance had been followed. Patients were cared for in a clean, hygienic environment. Patients we spoke with told us that they always found the practice to be very clean, tidy and organised.

Patients were cared for, or supported by, suitably qualified, skilled and experienced staff. Criminal Records Bureau (CRB) checks had been carried out for each staff member.

The provider had an effective system to regularly assess and monitor the quality of service that people received. Examples of audits undertaken included; decontamination, infection control, emergency drugs, radiographs, post treatment surveys and medical histories.