We carried out an announced comprehensive inspection on 17 May 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

Claire Rumley dental practice is a small NHS dental practice located in the Hall Green area of Birmingham. The provider, Claire Rumley is one of three dentists who work in the same building under a separate registration with the Care Quality Commission (CQC). Some of the facilities and staff are shared between each practice located in the building. For example the receptionist, reception area, toilets, staff room, waiting area and first floor X-ray facilities are used by all three dental practices under an expense sharing agreement. This report will make references to the practice but this inspection only related to the services provided by Dr Claire Rumley.

The practice is located on the ground floor, with one treatment room and provides regulated dental services to both adults and children. Three qualified dental nurses and a receptionist work alongside the dentist. The practice’s opening hours are: Monday, Tuesday, Thursday and Friday: 8.30am to 5.30pm; and Wednesday: 8.30am to 1pm.

The dentist is registered with the CQC as an individual. 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.

We received positive feedback from 52 patients about the services provided. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

• Systems were in place for the recording and learning from significant events and accidents.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.
• Feedback from patients about their experiences at the practice was positive. Patients said they were treated with dignity and respect.
• The dentist identified the treatment options, and discussed these with patients.
• The practice was visibly clean and well maintained.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• There was a whistleblowing policy accessible to all staff. Staff were aware of procedures to follow if they had any concerns.
• The appointment system met the needs of patients and waiting times were kept to a minimum.

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

• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review procedures to ensure that the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Review the storage of dental care records to ensure this is secure in accordance with the Data Protection Act 1998.
• Review its responsibilities to the needs of people with a disability and the requirements of the equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.

This review visit was discussed and arranged with the practice a few days in advance. This was to ensure that we had time to see and speak with staff working at the practice, as well as people registered with the practice where appropriate. We asked the staff at the practice to issue a questionnaire to some of the people who received a service. We received thirty eight completed questionnaires.

As part of our visit, we spoke with four people who were registered with the practice by telephone. We also spoke with the dentist and their staff about working at the practice.

People that used the practice told us that they were happy with the quality of treatment received. They felt they were given enough information about their treatment options and the relevant fees, and were able to ask all the questions they wanted to.

Comments made in the questionnaires we received from people using this practice included:-

‘It’s almost a pleasure to go there.’

‘Friendly staff.’

‘Never wait long and always explain treatment and try to make you feel as relaxed.’

‘Yes my dentist always explains what treatment I will be having and gives me a treatment plan.’

People told us that the practice was clean and tidy and had no concerns about hygiene standards.