We carried out an announced comprehensive inspection on 8 August 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

Kingsbridge Dental Centre is located in the market town of Kingsbridge, Devon. The practice provides primary dental care services for people who require dental procedures. The practice provides NHS dental treatment. There are four dental surgeries (one is situated on the ground floor and three are on the first floor). There are steps to the practice from the street and ramp access for people with mobility restrictions. Approximately 6,300 patients are registered at the practice; with patients travelling from nearby towns and villages to register and be seen at the practice. The majority of patients are adults.

The staff structure of the practice consists of a practice manager, four dentists, four reception staff, two dental nurses and two dental nurse trainees.

The practice is open from Monday to Friday from 9 am to 5.30pm. There are surgeries on Saturday mornings approximately once per month. There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice manager 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.

The inspection took place over one day and was carried out by a CQC inspector and a dentist Specialist Advisor.

Thirty five patients provided feedback directly to CQC about the service. All thirty five patients were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

Our key findings were:

• There were effective systems in place for the decontamination and sterilisation of dental instruments to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment text/phone reminders were available on request 48 hours prior to appointments.
• Oral health initiatives took place; there was a dedicated ‘kids club’ held three monthly at the practice for children and their parents on oral health and decay prevention in teeth.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke to felt supported by the management team and were committed to providing a quality service to their patients.

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

• Review the practice's recruitment policy and procedures with regard to the implementation of risk assessments when requests for references are not forthcoming.
• Review the storage of general cleaning materials to ensure the risk of cross infection is minimised at the practice.
• Develop systems to publicise the action taken by the practice as a result of patient feedback.

Kingsbridge Dental Centre provides a service to approximately 7,000 patients. The practice has two dentists, two dental nurses and one hygienist. There are three treatment rooms set over two floors. One of the treatment rooms is on the ground floor. There is disabled parking at the front of the practice and level access via the back door with one treatment room on the ground floor. This means that people with limited mobility are able to access the service.

We saw that the practice was clean, tidy and well organised. We spoke with five patients who were attending for examination or treatment. Their feedback was positive. One patient said “They always explain the choices available to me”.

People had been given advice about how to avoid tooth decay, and there were leaflets on display in the reception area with advice about maintaining oral health. A complaints procedure was displayed in the waiting area.

We looked at the comments received from patients via the practice feedback system. One patient had written “Very pleasant reception staff and a professional and understanding dentist”.

We spoke to five staff during our visit and found they had received appropriate training for patient care. We looked at records and found them to be accurate, up to date and stored securely.