We carried out an announced comprehensive inspection on 9 November 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

Globe Dental Practice is located in the centre of Nantwich and comprises a reception and waiting room and one treatment room on the ground floor, and a further two treatment rooms on the first floor. Parking is available on nearby streets and in car parks. The practice is accessible to patients with disabilities, impaired mobility and to wheelchair users.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday to Thursday 9.00am to 5.00pm, Friday 9.00am to 4.00pm. The practice is also open on the first Saturday of every month from 9.00am to 1.00pm. The practice is staffed by two principal dentists, an associate dentist, two dental hygienists, three dental nurses, a reception manager and a trainee receptionist.

One of the principal 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.

We received feedback from 21 people during the inspection about the services provided. Patients commented that they found the staff were friendly and caring. They said that they were always given helpful explanations about dental treatment, and that the dentists listened to them. Patients commented that the practice was clean and comfortable but would benefit from redecorating.

Our key findings were:

• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• The premises and equipment were clean and secure.
• Staff followed current infection control guidelines for decontaminating and sterilising equipment.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised and felt comfortable to raise concerns should they arise.
• The practice had procedures in place to record and analyse significant events and incidents but they were not recording all significant events.
• Three staff had not received formal safeguarding training, but we found that all staff knew the processes to follow to raise concerns.
• Governance arrangements were in place for the running of the practice.

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

• Review the practice’s arrangements for responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency and through the Central Alerting System, as well as from other relevant bodies such as, Public Health England.
• Review the practice’s system for the recording, investigating and reviewing of incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result
• Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
• Review the practice’s infection control procedures and protocols having due regard to 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, specifically in relation to the security of the decontamination room, and the monitoring of water temperatures to assist in minimising the risk from Legionella.
• Review the protocols and procedures for the use of X-ray equipment having due regard to guidance notes on the safe use of X-ray equipment, specifically in relation to the use of rectangular collimation and the decommissioning of unused X-ray machines.
• Review the protocols and procedures to ensure all staff are up to date with their mandatory training and their continuing professional development, including safeguarding training to a recognised level, and medical emergencies and life support training.