We carried out an announced comprehensive inspection on 9 March 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

Insley Dental Practice is located in a residential suburb close to the centre of Macclesfield and comprises a reception and waiting room, two treatment rooms and patient toilet facilities on the ground floor, and a further treatment room on the upper floor. Parking is available outside the practice. The practice is accessible to patients with disabilities, limited mobility, and to wheelchair users.

The practice provides general dental treatment to patients on a privately funded basis. The practice also offers specialist oral surgery treatments and treatment with sedation. The opening times are Monday to Friday 8.00am to 6.30pm. The practice is staffed by a principal dentist, two associate dentists, a specialist oral surgeon, a practice manager who is also a dental nurse, a dental hygienist, and four dental nurses, three of whom also undertake reception duties.

The principal dentist is registered with the Care Quality Commission as an individual. 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.

We received feedback from 26 people during the inspection about the services provided. Feedback was highly positive about all aspects of the service. Patients commented they found the service excellent, and that staff were professional, friendly, attentive and caring. They said the dentists listened to them and they were always given clear, informative explanations about dental treatment. Several patients with specific needs identified that the practice had gone out of their way to meet their needs. Feedback highlighted that dental treatment was exceptional. Patients commented that the practice was welcoming, clean and comfortable and provided a relaxing environment.

Our key findings were:

• The practice had procedures in place to record, analyse and learn from significant events and incidents.
• Staff had received safeguarding training, and knew the processes to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• The premises and equipment were clean, secure and well maintained.
• Staff followed current infection control guidelines for decontaminating and sterilising instruments.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current standards and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• Services were planned and delivered to meet the needs of patients.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

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

• Review the practice’s sharps procedures having due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 to ensure responsibility for dismantling and disposal of all sharps is considered.
• Review the practice’s audit protocols for sedation processes to help improve the quality of the service, specifically in relation to the maintenance of sedation equipment.

During our visit to the practice we spoke with three patients who had appointments that day. They were all very positive about the service provided and the staff at the practice. For example, one patient said, “Everyone is really friendly and very easy to talk to”. Another patient said, “All the staff are pleasant, polite and welcoming”. And another said, “I was nervous about my treatment but staff reassured me and I had a good experience. I did not feel rushed at all and it was better than I expected”.

All the patients said they had enough information about the services and treatment provided and that treatment options and plans were fully explained to them including what to expect, the risks and benefits and the costs. They told us they got appointments at convenient times and generally they did not have to wait too long.

Patient also told us they were happy with the care and treatment they receive and had confidence in the skills of staff. For example, one patient said, “The service is of high quality. I’ve been impressed by the treatment I have received and I am confident in the experience and knowledge of staff”. They said they had had their medical history taken and this information was regularly updated when they came for check-ups or treatments. They said they were given advice when necessary, for example on oral hygiene.

All the patients we spoke to commented positively on the cleanliness of the practice including the waiting room and the dental surgeries. They told us they saw staff practising good hand hygiene and wearing protective equipment.