We carried out an announced comprehensive inspection on 16 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

Dental Practice is situated in Waltham, South Humberside. 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 has one surgery, a decontamination room, a waiting area and a reception area. All of the facilities are on the ground floor of the premises along with toilets.

There are two dentists (one who also works as a dental nurse and practice manager), one receptionist and a practice co-ordinator.

The opening hours are Monday to Thursday from 11:00am to 6:30pm.

One of the 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.

During the inspection we spoke with three patients who used the service and reviewed one completed CQC comment card. The patients were positive about the care and treatment they received at the practice. Comments included the practice was clean and hygienic and staff were friendly, helpful and listened to their concerns.

Our key findings were:

• The practice was visibly clean.
• The practice had systems to help them manage risk.
• Staff were qualified and had received training appropriate to their roles.
• Improvements could be made to the practice’s process for documenting evidence of informed consent.
• 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.
• Patients were able to make routine and emergency appointments when needed.
• 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 protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the practice’s process for documenting evidence of informed consent.
• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.
• Review the practice’s protocols for taking X-rays taking into account guidance provided by the Faculty of General Dental Practice “Selection criteria for Dental Radiography”.
• Review the practice’s risk assessment for the use of personal protective equipment (in particular eye protection).
• Review the practice’s audit protocols for infection prevention and control to help improve the quality of service. Practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.

We spoke with three people during our inspection. They told us they had sufficient time to ask questions and fully understand the proposed treatment. One person told us, “The dentist tells me what treatment I need and then I make an appointment to have the treatment.”

Discussions with the practice manager and staff showed a good understanding of consent. They told us how each person was treated as an individual and that every time they visited the practice they were asked for their consent to treatment.

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. People told us the practice was always accommodating to ensure appointments were flexible to meet their needs.

There were effective systems in place to reduce the risk and spread of infection. People told us the practice facilities were always clean and well maintained. One person said, "The dentist does everything by the book. They are very professional. The surgery is always clean and tidy."

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. Staff received appropriate training to ensure they had the skills and knowledge to meet people's needs.

The provider had an effective system to regularly assess and monitor the quality of service that people received. People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.