We carried out an announced comprehensive inspection on 6 September 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

Ise Lodge Dental Care is located in a quiet residential area of Kettering. The practice is in a converted, modern bungalow with access for disabled people. The practice has a waiting room where up to ten people can be seated and three treatment rooms that are accessed from the reception area.

The principal dentist is registered with the Care Quality Commission (CQC) 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.

As part of the inspection, we received feedback through 41 CQC comments cards completed by patients, speaking with other patients and staff during the inspection. Patients said that the staff were caring and helpful to them and they received good care and treatment.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• There were systems to promote the safe operation of the service although the reporting of incidents and significant events required development.
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice although one medicine was found to be incorrectly stored and out of date.
• Patients told us they were able to get an appointment when they needed one and the staff were kind and helpful.
• Dentists provided dental care in accordance with current guidelines from the Faculty for General Dental Practice guidelines and the National Institute for Care Excellence (NICE).
• Staff had good access to training and were supported to develop their knowledge and maintain their professional development.
• Governance arrangements were in place although these required strengthening to maintain the safety of the service and promote ongoing learning and improvement.

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

• Strengthen systems used to monitor quality and safety in relation to incidents, accidents, significant events, complaints and environmental risks.
• Review the process used to act on the outcomes of clinical and non clinical audits so that actions taken are clearly evidenced and can be monitored.

• Review the storage of dental care products and medicines that may require refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
• 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 Gillick competency and the Mental Capacity Act (2005) to ensure all staff are aware of their responsibilities.
• Review the practice’s sharps procedures in relation to the management of sharps injuries giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review staff records so that records of Hepatitis B immunity are monitored.
• Review ongoing systems to monitor infection control practice in the treatment rooms so that all dental items are hygienically stored, supplies of materials and equipment are checked and records of cleaning completed.

We spoke with five patients who attended the practice on the day of our inspection. All the patients we spoke with were highly complimentary about their experience of the practice. Each patient told us that their treatment plans and fees had been explained to them in ways that they understood. Two patients told us that their dentist had reassured them about their anxieties about dental treatment. All the patients we spoke with told us they felt involved in their treatment plans. One patient told us, "My dentist is very good at explaining treatment and why it's required. He's given me advice about how I can look after my dental care. I can ask anything about my treatment." Another patient told us, "I lost my confidence because of an experience elsewhere. I never feel anxious here." Another patient told us, "I never feel pain during treatment."

Patients we spoke with were complimentary about the staff. One told us, "I'm always met with a smile." All the patients we spoke with told us that they thought the practice was very clean. Another patient said, "The dentists are superb. The whole practice is well organised."

What patients told us reflected what patients had said in a recent survey about being involved, informed and well treated.

We found that the provider was comfortably meeting all of the standards we inspected.