We carried out an announced comprehensive inspection on 15 February 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

East Midlands Community Dental Association - Grantham is situated in a large period building close to the town centre. The practice had four treatment rooms, two reception desks, a decontamination room and a disabled toilet. There was a small room behind the main reception desk which was used to store practice documents and a second desk area where the practice manager worked from. On the first floor there was a staff room and staff toilet. There is pay and display parking available in a large car park near to the practice and on street parking up to 30 minutes. The building is accessed from the street and there is a ramp and handrail in addition to steps to make it accessible to people who use wheelchairs or have mobility problems.

There are five dentists, two of which are full time alongside two dental nurses, two trainee dental nurses and two reception staff. The practice has a dental hygienist that works at the practice twice a month. In addition to this the practice has a manager that is also a qualified dental nurse. The practice manager also manages a sister practice in Lincoln and time is split between both practices. The practice manager is at the Grantham practice two days per week.

The practice provides predominantly NHS dental treatment to adults and to children. The practice is open Monday to Friday from 9am to 5.30pm and Saturday 9am to 12pm.

The practice is part of Genesis dental care which is a provider with 11 practices in total. The registered manager is a director of the company. 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.

We received feedback from 22 patients about the services provided. The feedback reflected positive comments about the staff and the services provided. Patients commented that the practice was clean and tidy and that it was welcoming. They said that they found the staff offered a friendly, professional and efficient service and were polite, helpful and kind. Patients said that explanations about their treatment were clear and that they were given time and listened to. Patients who were nervous commented how the dentist was understanding and patient; they were made to feel at ease and that any questions were answered.

Our key findings were:

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in place and staff had access to personal protective equipment however there was no separate hand washing sink as recommended (HTM 01-05)
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies and appropriate medicines and life-saving equipment were readily available and accessible
• Governance systems were effective and policies and procedures were in place to provide and manage the service.
• Staff had received formal safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities.

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

• Review published guidance (HTM 01-05) in relation to hand washing in relation to the design of the decontamination rooms.
• Ensure all audits have learning points documented and resulting improvements can be demonstrated.

We spoke with three patients about their experience of care and treatment provided by the practice.

All the patients we spoke with talked positively about the service they received. They told us it was easy to make an appointment that suited their needs and waiting times were good.

One patient told us, “I needed an emergency appointment today and I got one easily.” Another patient said, “I get plenty of choice of appointments, you usually get seen within five minutes of your appointment time.”

The patients we spoke with told us they felt they received enough information about the treatment options available to them.

One patient told us, “The dentist takes time to explain the options to me but I always ask for their recommendation.” Another patient said, “I am more than satisfied with the service I receive.”

We asked patients how they found the staff. All the patients we spoke with told us they thought the staff were very friendly, warm and welcoming.

One patient told us, “I find all the staff friendly and welcoming, their approach makes me feel less anxious.”

All the patients we spoke with told us they thought the practice was clean and they felt safe with the treatment provided.