We carried out an announced comprehensive inspection on 7 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

Greengates Dental Practice is situated in Bradford, West Yorkshire. The practice offers mainly NHS dental treatments to patients of all ages and also offers private treatments. The services include preventative advice and treatment and routine restorative dental care.

The practice has three surgeries, a decontamination room, a waiting area and a reception area. The reception area and waiting area are on the ground floor of the premises. The three surgeries are on the first floor.

There are three dentists, one dental hygienist, three dental nurses, one receptionist and a practice manager.

The opening hours are Monday to Friday from 8-00am to 5-30pm.

The practice owner 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

During the inspection we received feedback from three patients. The patients commented they were able to make an appointment easily, they were involved in treatment decisions and they were provided with oral hygiene advice.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• The practice had a complaints system in place which was available for patients.
• Patients were able to make routine and emergency appointments when needed.
• There were clearly defined leadership roles within the practice and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.
• The governance systems were a work in progress. Some polices had not been reviewed recently and a risk assessment of the building had not been completed.
• There was not an effective system in place to audit the quality and safety of the practice.

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

• Review the practice’s system to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the practice’s process to ensure equipment is maintained in line with the manufacturer’s guidance.
• Review the practice’s process to ensure audits of various aspects of the service, such as radiography, infection prevention and control and dental care records are undertaken at regular intervals to help improve the quality of service. Practice should also ensure all audits have documented learning points and the resulting improvements can be demonstrated.