We carried out an announced comprehensive inspection on 15 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

Leven Vale Dental Practice is situated on the outskirts of Yarm, a small market town in Cleveland. The practice occupies a purpose-built ground floor premises and provides predominantly NHS treatment to patients of all ages. There are three treatment rooms, an open-plan reception and waiting area, a dedicated decontamination room for sterilising dental instruments, two changing /storage rooms, a staff kitchen and a general office. Car parking is available within the practice grounds. Access for wheelchair users or pushchairs is possible via the ramp outside and within the entire building.

The practice is open Monday to Thursday 0900-1700 and Friday 0900-1600.

The dental team is comprised of the principal dentist, an associate dentist, a foundation dentist, three qualified dental nurses (one being the administration lead), a trainee dental nurse and a receptionist.

The practice provides general dentistry and is actively involved in vocational foundation training for newly qualified dentists (foundation training enables newly qualified dentists to work within the National Health Service (NHS) system). The practice is passionate about oral health promotion and was involved in community programmes (fluoride varnish application and oral health education) within schools over the last two years. A programme is currently under review for next year.

The principal dentist is the registered provider. A registered provider has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We reviewed 41 Care Quality Commission (CQC) comment cards on the day of our visit; patients were very positive about the staff and standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• All staff were welcoming and friendly.
• The practice was well organised and the premises was visibly clean and free from clutter.
• An infection prevention and control policy was in place and sterilisation procedures followed recommended guidance.
• The practice had systems for recording incidents and accidents.
• Practice meetings were used for shared learning.
• The practice had a safeguarding policy and staff were aware on how to escalate safeguarding issues for children and adults should the need arise.
• Staff received annual medical emergency training.
• The practice was actively involved in promoting oral health.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patients could access urgent care when required.
• Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
• Patient feedback was regularly sought and reflected upon.
• Complaints were dealt with in an efficient and positive manner.

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

• Review the practice’s recruitment policy and procedures to ensure that all staff undergo Disclosure and Barring Service (DBS) checks prior to employment.
• Review the practice’s legionella risk assessment. Implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review the practice’s procedures for undertaking six-monthly infection prevention and control audits as recommended by the Department of Health: Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices.
• Review the practice’s procedures for undertaking staff satisfaction surveys to help improve the quality of service.
• Review the practice responsibilities with regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 to ensure all documentation is up to date and staff understand how to minimise risks associated with the use and handling of these substances.

We spoke to people who used the service, who told us they were happy with the service, and that their treatments and any fees were explained thoroughly to them before treatment commenced. Comments from people included “The service has been very good” “It’s been absolutely fine, no concerns at all” and "It's always nice and clean and friendly". People were also asked for their views on the service.

All the people we spoke to were very satisfied that they had received appropriate care, treatment and support, with comments including " I've never had a problem with anything here". Medical history and patient details were sought before treatment commenced. There were appropriate arrangements in place to deal with any emergencies.

The practice had appropriate policies and procedures in place for infection control and the decontamination of dental instruments. We observed staff following these procedures correctly. This ensured that people were cared for in a clean, hygienic environment.

Staff were appropriately skilled and trained for their work, and said they felt well supported within the workplace. The provider carried out appropriate auditing of the practice and sought patient feedback to ensure a good service was provided.