We carried out an announced comprehensive inspection on 6 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

Gargrave Road Dental Practice is located near the centre of Skipton in North Yorkshire and provides private treatment to adults and children. They offer restorative dentistry, dental implants, orthodontics and cosmetic treatments.

Wheelchair users or pushchairs can access the practice through a ramp access at the rear of the building. Car parking is available near the practice.

The dental team is comprised of a dentist, four dental nurses (one of whom is a trainee), two dental hygienists, and a cleaner.

The practice accommodates three surgeries, a waiting area and reception, and a staff room/kitchen.

On the day of inspection we received 31 CQC comment cards providing positive feedback. The patients were complimentary about the care they received at the practice. They told us they found the staff caring and compassionate.

The practice is open: Monday, Tuesday, and Friday 9am-5pm and Wednesday 8:30am-4pm.

The principal dentist is registered with the Care Quality Commission (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.

Our key findings were:

• The practice appeared clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• Staff had been trained to handle medical emergencies and appropriate medicines and equipment were readily available in accordance with current guidelines.
• The practice had systems in place to manage risks.
• Staff understood and received safeguarding training and knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Treatment was well planned and provided in line with current guidelines.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The service was aware of the needs of the local population and took these into account in how the practice was run
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The practice sought feedback from staff and patients about the services they provided.
• Complaints were responded to in an efficient and responsive manner.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Recruitment needed to be brought in line with the recruitment procedure.
• Staff kept up to date with the professional training but we noted that staff appraisals were not in place.

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

• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal references taken and ensuring recruitment checks, including references, are suitably obtained and recorded.

• Review the learning and development needs of individual staff members and have an effective process established for the on-going assessment and appraisal of all staff.

We talked with two people who were receiving treatment during our visit. They confirmed they were consulted about the options available to them and given information to help them make decisions about their treatments. They also said that they were happy with the care and treatment they received. Comments made included, “I think this service is excellent” and, “I am very happy here. When I walk through the door I am made to feel welcome, they know who I am and make me feel at ease” and also, “I do not regret changing to this dentist. All my care has been excellent."

We looked at treatment records and we confirmed treatment was appropriately planned and recorded.

We also looked at the infection control procedures in place. We saw there were robust procedures in place and that staff had suitable guidance to ensure that equipment was cleaned, decontaminated and sterilised. We also saw that suitable arrangements were in place to provide emergency first aid and resuscitation if needed.

We saw that staff had many opportunities to keep up to date with their training and personal development. Staff told us that they met regularly to talk about their practice and that they felt well supported in their work.

Information about how to make a complaint was available to people who used the service. People confirmed that they felt able to raise any concerns they had directly with the dentist and staff if they needed.