We carried out an announced comprehensive inspection on 18 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

ICE Surgeries Limited is located in ground floor premises situated in the village of Radcliffe on Trent to the east of Nottingham. There are three treatment rooms. The practice provides mostly NHS dental treatments (90%). There is a free time limited car park for dental patients outside 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 and Wednesday: 8:30 am to 7 pm; Tuesday and Thursday: 8:30 am to 5:30 pm; Friday 9 am to 2 pm. The practice is closed for lunch 1 pm to 2 pm Monday to Thursday.

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 in Nottingham through the 111 telephone number.

The practice manager and the principal dentist were both registered with the Care Quality Commission (CQC) as registered managers. 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.

The practice is registered with the CQC as an organisation.

The practice has three dentists; one hygienists; four qualified dental nurses; one trainee dental nurse; two receptionists; and one practice manager.

Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from 50 patients through both comment cards and by speaking with them during the inspection. Those patients provided positive feedback about the services the practice provides.

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.
• The practice had a robust consent policy including reference to the Mental Capacity Act 2005.
• Patients said they had no problem getting an appointment that suited their needs.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
• Dental care records demonstrated that 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, oxygen and emergency medicines.

During our visit we spoke to two patients, one dentist working within the practice, two members of practice staff and the practice manager.

Patients we spoke to were involved in their care and treatment options, felt it was delivered in a safe way and that the practice was clean and hygienic. One patient said, “The staff are lovely and it is a very good dentist. I didn’t feel a thing when I had my filling done.” Another patient said, “The dentist has been good. They saw me quickly one evening when I was in discomfort.”

We observed members of staff interacting with patients in a courteous, polite and efficient manner.

We saw that the practice had implemented an infection control policy and that staff were encouraged to develop their skills and undertake appropriate training to help deliver safe and effective care to patients. One member of staff said, “I have confidence in the practice manager. I could raise anything in confidence if I needed to."

We looked at information from surveys and other audits undertaken by the provider to assess the quality of the service.