We carried out an announced comprehensive inspection on 25 January 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

Hafren House Dental Practice is located in ground floor premises situated in the town of Alfreton in north Derbyshire. There are three treatment rooms, two of which are on the ground floor. The practice provides mostly NHS dental treatments (95%). There is a pay and display car park for dental patients a short distance from the practice.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday: 8:45 am to 5 pm; Tuesday: 8:45 am to 5 pm; Wednesday: 8:45 am to 6 pm; Thursday: 8:45 am to 5 pm and Friday 8:45 am to 5 pm. The practice closed for lunch between 1 pm and 2 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number. An NHS out-of-hours dentistry service also operates locally Derbyshire Emergency Dental Service (DEDS) and the practice make their telephone number available to patients.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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.

The practice has three dentists; one hygienist/ therapist; five qualified dental nurses; one receptionist and one practice manager.

On the day of inspection we received 49 CQC comment cards providing positive feedback and we spoke with patients. Among the themes we identified from patient feedback were the reception staff were friendly and approachable, confidentiality was respected, dentists were caring and explained what was happening and the options for treatment, the premises were clean and there was plenty of information available.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• The systems to record accidents, significant events and complaints, learning points from these were recorded and used to make improvements.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• There were effective systems at the practice related to the Control of Substance Hazardous to Health (COSHH) Regulations 2002.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. They told us they were treated with dignity and respect and had no problem getting an appointment to suit their needs.
• Dental care records demonstrated the dentists involved patients in discussions about treatment options.
• Patients’ confidentiality was protected within the practice.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, medical oxygen and emergency medicines.

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

• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We spoke with a dentist about how they obtained the consent of people who used the service. We were told about the process of describing treatment options that were available to people and how to present this in a way the person understood.

We spoke with two people who had received treatment at the time of our visit. We asked them about the care and treatment they had received. Comments included: “they’ve always explained things and shown me my X-Rays”, “they really are very good” and “they all seem competent and capable…..absolutely brilliant”.

There were effective systems in place to reduce the risk and spread of infection. We reviewed the infection prevention and decontamination policies and found them to be up to date and comprehensive with responsibilities clearly defined.

We found there were effective recruitment and selection processes in place and staff had access to regular training.

The provider had an effective quality assurance system to monitor the quality of service provided.