We carried out an announced comprehensive inspection on 17 February 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

Leyburn Dental Practice - Wensley Road is located in Leyburn, North Yorkshire and provides NHS and private treatment to adults and children.

Wheelchair users or pushchairs can access the practice through step free access. Car parking spaces are available at the practice.

The dental team is comprised of three dentists who are directors, five dental nurses, a dental hygienist, a dental hygiene therapist, a receptionist and a practice manager.

The practice has recently been refurbished to accommodate five surgeries, a decontamination room, a waiting area and reception, a staff room/kitchen and a general office.

On the day of inspection we received 49 CQC comment cards providing positive feedback. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to provide exemplary care; staff were attentive and communicated well. Patients commented they could access emergency care easily and they were treated with dignity and respect in a clean and tidy environment.

The practice is open: Monday – Thursday 9am -5pm

Friday 9am -4pm

Saturday appointments were available by prior arrangement and at the discretion of the practice.

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.

Our key findings were:

• The practice appeared clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice had systems in place manage risks.
• Staff understood and received safeguarding training and knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Effective recruitment processes of staff were in place.
• Treatment was well planned and provided in line with current guidelines.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The service was aware of the needs of the local population and took these into account in how the practice was run
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The practice sought feedback from staff and patients about the services they provided.
• Complaints were responded to in an efficient and responsive manner.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.

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

• Review the process to ensure the practice investigates and reviews incidents and significant events with a view to preventing further occurrences, ensuring that improvements are made as a result.
• Review the protocol to ensure accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including DBS checks and immunisation status are suitably obtained and recorded.
• Review the process and procedures for domiciliary care for patients who could no longer access their services. Implement risk assessments and ensure access to medical emergency drugs and equipment is in line with the guidelines for the delivery of a domiciliary oral healthcare service 2009.

We talked with people who used the service and they told us they were happy with the quality of dental treatment offered. People said they felt they were involved in decisions about their treatment. Comments included "I am told what to expect and how much it will cost, the service is really good”. And “The dentist explains everything to me in word that I can understand." Another person said " The staff are great, very pleasant and always professional.”

We looked at some dental records for the people who used the service and these confirmed that people were involved in decisions regarding their treatment.

We found the premises clean and the surgeries and building were well maintained. We also saw that audits were completed and saw evidence that procedures were in place to ensure people's health and safety. We talked to staff about their experiences working for this service. Some of the staff had worked for many years for this practice. Comments included: "We are encouraged to keep up to date in our training and development.” And “There is a lot of support here we all work really well together.”

We saw that thier was a complaints policy in place for people who wished to raise any concerns and the practice manager said that although they had not had anything raised with them, they were always willing to learn and improve on the service they offered in order for patients to be happy with the treatment and service.