We carried out an announced comprehensive inspection on 26 January 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

Hitchin Dental is a mixed NHS and private practice situated in the town centre of Hitchin, a market town in Hertfordshire.

The practice has 11 treatment rooms spread over two floors in a converted building. There is a waiting room on each floor, an X-ray room and an office in the main part of the building, with a conference room and staff room accessible via an external door in another area of the building.

The practice offers a full range of general dental procedures for adults and children.

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

Prior to the inspection we left comment cards at the practice for patients and visitors to the practice to feedback about their experience. We also spoke to patients as part of our inspection. In total 27 people provided feedback about the service. The comments received were highly positive and pointed to the staffs’ friendly and professional manner, and how patients feel they are listened to, and their needs met.

Our key findings were:

• Patients commented that they were treated with care and compassion and that their options for treatment were explained to them.
• The practice met the essential standards in infection control as set out in the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.’ Published by the Department of Health.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained

• The provider kept emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.

• The practice had implemented a scheme of comprehensive training to prepare trainee dental nurses for the national examination in dental nursing.

• We identified the following example of notable practice that merits sharing during our inspection of Hitchin Dental: The practice was committed to the promotion of oral health particularly in children the practice blocks routine appointments in the half term holidays so that priority can be given to children needing to access dental care. 

• Clinical audit that was completed to highlight areas in the practice that could be improved did not always have documented action plans or learning points to facilitate the improvement.

• We identified the following example of notable practice that merits sharing during our inspection of Hitchin Dental:

  The practice had implemented a comprehensive training programme for dental nurses.

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

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 with particular reference to the use of safer sharps across the practice.

• Review audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.

• 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.

During our visit we spoke with a number of patients who had visited the practice on the day. They were all complimentary about the service and the treatment they had received. One person said "The best dentist I have been to. Staff are very friendly." Another person said "The dentists are brilliant with children. I am a nervous patient, but they make me feel at ease and they listen to me." One child told us, "I like coming here. The dentist is good. They explain to us how to look after our teeth and how to brush them."

We found that the provider was meeting the standards we had inspected. People had been involved in the decisions about their treatment. Their privacy and dignity were respected. The records we had reviewed showed that each person had a treatment plan including the costs. There were systems in place to control the spread of infection and monitor the quality of service.