During our announced comprehensive inspection of this practice on the 25 October 2016, we found a breach of legal requirements in relation to the Health and Social Care Act 2008. Following this inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to regulation 17- Good Governance.

We undertook this focused inspection to check that the provider had followed their improvement plan and to confirm that they were now complaint with the regulation. This report only covers our findings in relation to this requirement. You can read the report from our previous comprehensive inspection, by selecting the 'all reports' link for Littleport Dental Surgery at www.cqc.org.uk

Are services Well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Key findings

• Overall, we found that effective action had been taken to address the shortfalls identified at our previous inspection and the provider now met the regulation. Robust systems had been implemented to ensure continued compliance.

We carried out an announced comprehensive inspection on 25 October 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 not providing well-led care in accordance with the relevant regulations.

Background

Littleport Dental Surgery is a well-established dental practice that provides mainly NHS treatment to adults and children. The team consists of five dentists, two hygienists, four dental nurses and a practice manager. The practice has three ground floor treatment rooms, a separate room for the decontamination of instruments, a staff room, a reception and two waiting areas.

It is open from 8am to 5pmMonday to Fridays.

One of the principal dentists 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.

Before the inspection we sent comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 10 patients who commented positively about the quality of the service, the friendliness of staff and the effectiveness of their treatment.

Our key findings were:

• Patients were treated in a way that they liked and were involved in decisions about their treatment. They could access treatment and emergency care when required.

• There were some arrangements in place for identifying, recording and managing risks and implementing mitigating actions

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was appropriate equipment for staff to undertake their duties, and most equipment was well maintained. However, the practice did not have access to an automated external defibrillator in the event of a medical emergency and we found an out of date oxygen cylinder.

• The practice was visibly clean and well maintained. However, infection control and decontamination procedures did not meet national standards.

• There were sufficient numbers of suitably qualified and competent staff. Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• Patients’ care and treatment was planned and delivered in line with evidence-based guidelines, best practice and current legislation. Patient dental care records were detailed and comprehensive.

• The practice listened to its patients and staff and acted upon their feedback.

• Auditing systems within in the practice were not effective enough to ensure a good service was delivered to patients.

We identified regulations that were not being met and the provider must:

• Ensure effective systems and processes are established to assess and monitor the service against the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and national guidance relevant to dental practice. This must include ensuring that decontamination procedures meet national guidance, that adequate staff recruitment checks are completed, that the need for an automatic electronic defibrillator is reviewed, and that effective systems of audit are implemented.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA).

During our inspection on 01 February 2013 we spoke with six people who offered positive comments about their treatment and the dental care they had received. One person said, "I have been given excellent treatment today. I was spoken to very politely and I like coming here". Another person said, "What can I say, I have no complaints but I don't like going to see any dentist".

Dental records that we saw contained details of the treatment provided at each appointment people had attended.The records showed that people had been asked about their health and medication at each appointment. Immediate arrangements must be put in place by the provider to ensure that emergency resuscitation can be provided, should this be necessary at any time.

Safeguarding policies and procedures were in place. Staff had received training to safeguard children but had not received training for safeguarding vulnerable adults.

We were advised by the providers that the premises were soon to be refurbished. We noted that the premises paintwork was looking tired and that the design of the reception area did not allow people to have easy access to the reception staff.