We carried out an announced comprehensive inspection on 22 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

Loughborough Road Dental Practice is located in premises situated in the West Bridgford area of Nottingham. There are six treatment rooms three of which is situated on the ground floor. The practice provides mostly private dental treatments (75%) There is a small car park for dental patients to the rear of the practice.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday: 8:30 am to 5:30 pm; Tuesday: 8:30 am to 5:30pm; Wednesday: 8:30 am to 7:30 pm; Thursday: 8:30 am to 5:30 pm and Friday: 8:30 am to 5:30 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients can telephone the NHS 111 telephone number. An NHS out-of-hours dentistry service also operates in Nottingham.

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 practice has four dentists; four hygienists; ten qualified dental nurses including the practice manager and one receptionist.

Before the inspection we sent CQC comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received responses from 55 patients through both comment cards and by speaking with them during the inspection. In addition CQC received 63 comments directly from patients at the practice. Patients provided positive feedback about the services the practice provides, this was both in writing and in person during the inspection. Among the themes we identified from patient feedback were that confidentiality was maintained, staff were welcoming, patients were happy with the standard of treatment they received and patients felt involved.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• The systems to record accidents, significant events and complaints, learning points from these were recorded and used to make improvements.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• There were effective systems at the practice related to the Control of Substances Hazardous to Health (COSHH) Regulations 2002.
• The practice had a consent policy including reference to the Mental Capacity Act 2005.
• Patients were able to access emergency treatment when they were in pain usually the same day.
• Patients provided positive feedback about their experiences at the practice. Patients said their confidentiality was protected and they were treated with dignity and respect.
• Dental care records demonstrated that the dentists involved patients in discussions about treatment options.
• The practice had taken positive steps to protect patients’ confidentiality.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns about a colleague’s practice.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, medical oxygen and emergency medicines.
• An access audit had been completed to assess the needs of patients who had restricted mobility.
• The practice had taken steps to ensure the physical environment was accessible to patients who had a disability.
• The practice did not have an induction hearing loop to assist patients and visitors who used a hearing aid.

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

• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum01-05: 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. With particular regard to six monthly infection control audits.

• Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and consider installing a hearing induction loop to assist patients and visitors who used a hearing aid.

We were only able to speak with two patients during our visit; however we did observe a number of other patients attending the practice for their appointments and treatment. We saw patients were treated with respect and dignity at all times. One patient said, “Staff always speak to me in a polite manner and they are very attentive to my needs.”

Patients told us they were able to make informed choices and the dentist always listened to them, which ensured they were involved with the decisions that were made regarding their treatment.

The practice was a three story building with disabled access and patient facilities. There were six surgeries available to patients, with three being on the ground floor for easy access for patients with walking difficulties.

There were two waiting areas one on the ground floor and one on the first floor. The main reception was separate to the waiting areas and patients were able to discuss their needs in private.

We saw information for patients use in the waiting areas of the practice. This included information regarding dental implants, the practice user guide and a News leaflet, which included further information on how to access the practice website.