People we spoke with during our visit told us they were satisfied with their treatment at Hatfield Peveral surgery.

People informed us that they received information in a calm and unhurried environment. People told us that they never felt under pressure to make a decision and options were always discussed with them. They told us that staff listen to them and were approachable. People confirmed they felt safe with their treatments and that they would talk to the dentist if they had any concerns.

Comments from people included “The dentist always takes time to discuss options” and “I have had my confidence in smiling restored.” One person said “The whole service is marvellous I was recommended this dentist and I would recommend him to anyone.”

During our visit people were seen to be relaxed and engaging with staff about treatments available.

We carried out an announced comprehensive inspection on 16 March 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

Hatfield Peverel Dental Surgery provides mostly NHS dental treatment to adults and children. It also provides a number of additional private treatments such as cosmetic crowns, tooth whitening and dental implants.

The practice has four dentists (principal, dentist, associate and foundation) working a variety of clinical sessions over a week. Three part time dental hygienists and four qualified dental nurses, three student dental nurses complete the clinical team. They were supported by a practice manager and receptionists. The practice opens from Monday to Thursday between 8am and 5.30pm and 8am to 2pm on Friday. Emergency appointments are available each day.

The practice is a training practice for the Dental Foundation Training (DFT) scheme. DFT provides postgraduate dental education for newly qualified dentists in their first (foundation) year of practice; usually within general dental practices. One of the principal dentists (also the registered manager) is a trainer for the DFT scheme and provides clinical and educational supervision. The practice currently has one dentist who is in their first (foundation) year of practice.

The practice’s premises consist of four treatment rooms, a patient waiting room, a sterilisation suite and a small staff room.

We spoke with five patients during our inspection and also received 47 comments cards that had been completed by patients prior to our inspection. We received many positive comments about the practice. Patients told us they were very happy with the quality of the dental care they received; that staff were professional and caring, and the practice’s hygienists had helped them manage and reduce their gum disease.

Our key findings were:

• Patients registered at the practice were told when they were affected by something that went wrong, given an apology and informed of any actions taken as a result.
• There was a system in place to learn from and make improvements following any accidents, incidents or significant events.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it
• The provider complied with patient safety alerts but there were not processes to cascade the information to all staff.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines. However a risk management process had not been undertaken for the safe use of sharps (needles and sharp instruments).
• Premises and equipment were clean, secure and mostly maintained. We identified that the radiography equipment had not been serviced according to manufactures recommendations.
• Patient care and treatment was planned and delivered in line with evidence based guidelines and current regulations; However a rubber dam was not used universally by all clinicians for root canal treatments as recommended by guidelines
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Members of the dental team were up to date on their continuing professional development in general dentistry; however clinicians’ undertaking sedation had not attained sufficient training as recommended by dental guidance.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients could access routine treatment and urgent care when required.
• There was an effective complaints system.
• The practice was well-led, staff felt involved and supported and worked well as a team.
• Audit process functioned well and had a positive impact in relation to quality governance, with clear actions to resolve concerns; however the x-ray audit had not been repeated since 2014.
• The practice sought feedback from staff and patients about the services they provided.

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

• Review the waste policy ensuring waste is segregated and disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• 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 staff awareness of 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 the practice’s protocols and procedures for promoting the maintenance of good oral health giving due regard to guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’
• Review the practice’s audit protocols of various aspects of the service, such as radiography at regular intervals to help improve the quality of service.