People we spoke with told us they were happy with the service they received. One person told us "I've been with this practice 25 years. Enough said!"

Staff treated people with courtesy and respect at all times and the dental practitioner ensured patients were involved with decisions about their dental care.

Staff were given appropriate training and support in their roles and were suitably qualified.

The practice had processes in place to ensure staff and patients were treated in a clean and safe environment.

The provider invited views of patients and regularly reviewed comments, acting on suggestions wherever possible.

We carried out an announced comprehensive inspection on 28 August 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

Elvet dental practice was established in 1920 and provides predominantly NHS treatment to patients of all ages. Situated in the centre of Durham, the practice occupies a listed three-storey building. Entrance is via the ground floor which contains a reception area, staff kitchen and a separate waiting room. There are three treatment rooms spread over the top two floors, a dedicated decontamination room for sterilising dental instruments and an office. Car parking is available on the streets in front of the practice. The practice is not able to accommodate patients with limited mobility due to building restrictions.

The practice is open Monday, Tuesday, Thursday and Friday 0900-1700 and Wednesday 0900-1800.

The dental team is comprised of two dentists, two receptionists, four dental nurses, an apprentice dental nurse and two dental hygienists. The senior dental nurse has managerial responsibilities whilst other staff are in defined lead roles.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 reviewed 18 CQC comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• The practice was well organised, visibly clean and free from clutter.
• An Infection prevention and control policy was in place. We saw the sterilisation procedures followed recommended guidance.
• The practice had systems for recording incidents and accidents.
• The practice had a safeguarding policy and staff were aware on how to escalate safeguarding issues for children and adults should the need arise.
• Staff received annual medical emergency training. Equipment for dealing with medical emergencies reflected guidance from the resuscitation council.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patient feedback was regularly sought and reflected upon.
• Patients could access urgent care when required.
• Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
• Complaints were dealt with in an efficient and positive manner.
• The organisation is actively involved in promoting oral health across the community.

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

• Review monitoring of their medical emergency equipment and medicines giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Review staff awareness of Gillick competency and the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

• Review their current legionella risk assessment and implement the required actions 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 the practice responsibilities in regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date.
• Review the practice’s fire risk assessment and procedures giving due regard to the The Regulatory Reform (Fire Safety) Order 2005.
• Review the practice’s protocol for recruitment checks to ensure all newly employed staff have up to date Disclosure and Barring Service (DBS) checks as per their recruitment policy.