We carried out an announced comprehensive inspection on 8 December 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

Located in the centre of Longton, the practice has three treatment rooms, one of which is on the ground floor. Treatment for adults is on a private basis either through a dental plan or private payment as treatment is received. The practice provides NHS funded treatment for children. Facilities are available for patients with limited mobility, including those who use mobility aids. There is a ramp for wheelchair or scooter access to the building and a stair lift to support access to the first floor. An accessible toilet is available on the ground floor. Two parking spaces are located to the front of the building and further parking is available close by.

The practice is open Monday to Thursday 8.30 am – 5.30 pm and 8.30am – 4.00pm on a Friday.

The practice closes for lunch 1.00pm – 2.00pm.

The practice owner is registered with the Care Quality Commission (CQC) as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008.

We reviewed feedback from eight patients as part of the inspection. Patients were extremely positive about the staff and standard of care provided by the practice. Patients commented that the practice was clean and they said they were involved in all aspects of their care. They said appointments were flexible and accommodating to their needs. Staff were described as helpful, respectful and friendly.

Our key findings were:

• The practice was well organised, visibly clean and free from clutter.
• Decontamination processes followed recommended guidance.
• Systems were in place for recording accidents and serious untoward incidents
• Staff had received training in child and adult safeguarding, and were aware of what constituted a safeguarding concern.
• Dentists provided treatment in accordance with current professional guidelines.
• Systems were in place for seeking patient feedback.
• Patients could access urgent care when required.
• A complaints process was in place and was displayed for patients.
• The practice was actively involved in promoting oral health.
• The premises had been adapted to support people with mobility needs.
• There were sufficient numbers of suitably qualified staff working at the practice.
• Staff were not up-to-date with annual medical emergency training. Equipment and medicines for dealing with medical emergencies was not in accordance with national guidance.
• A risk assessment had not been undertaken to address the circumstances when a safe sharp system was not used.
• The full range of recruitment checks were not in place for all staff.
• Policies and procedures were not up-to-date.

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) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal references taken and ensuring recruitment checks, including references, are suitably obtained and recorded.
• Review the practice’s responsibilities in relation to the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the availability of medicines, staff training and equipment to manage medical emergencies giving due regard to guidelines issued by the British National Formulary, Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• 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 the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013
• Review the way in which the practice’s policies and procedures are reviewed to ensure they are accurate and reflect national and local guidance.

The patients we spoke with all confirmed that staff treated them with respect. We were told; “They are sensitive to my concerns. I am not good in dentists.” And “They are polite, reassuring and friendly.”

People understood the care and treatment choices available to them and were involved in decisions about their treatment. Policies, good practice and staff training helped to ensure that patients received effective and safe treatment.

Policies and procedures were available in relation to infection control, with written protocols in place for instrument decontamination. Good practice routines minimised the risk of cross contamination.

Recruitment checks reduced the risk of employing unsuitable staff and offered protection to patients. The staff received a good level of support and training. The patients we spoke with told us they had full confidence in the staff at the practice. One person commented, “This is a brilliant surgery. I have never had any cause for complaint.”

There was a robust programme of quality monitoring, audits and checks. The practice had systems in place to monitor its own standards of service delivery and to gain feedback from patients.