We carried out an announced comprehensive inspection on 8 June 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

Malpas House Dental Surgery is located in Northallerton, North Yorkshire close to public transport links. The practice has three treatment rooms on the ground floor and two on the first floor. A reception area, a waiting room, a decontamination room, patient toilets, the staff room and office were located on the first floor.

There are four dentists (the senior partner/principal, two a partner/associates and one associate dentist), two dental hygienists and six dental nurses.

The practice offers predominantly private treatment but also has a small NHS contract; treatments include preventative advice, periodontal treatment and routine restorative treatment.

The practice is open:

Monday - Friday 09:00 – 17:00

One Saturday each month 09:00 – 13:00.

The principal dentist 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.

On the day of inspection we received 14 CQC comment cards providing feedback and spoke to three patients. 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 be friendly, helpful, efficient and professional and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines.
• The practice had a system in place for recording accidents and adverse incidents.
• Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations. Patients received clear explanations about their proposed treatment and were actively involved in making decisions about it. They were treated in a way that they liked by staff.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of the patients and waiting times were kept to a minimum. Emergency slots were available each day for patients requiring urgent treatment.
• There was a complaints system in place. Staff recorded complaints and cascaded learning to staff.
• The governance systems were effective.
• The practice sought feedback from staff and patients about the services they provided and used these to help them improve.

We spoke to four people who use the service, who all said their treatments and any fees were explained thoroughly to them before treatment commenced, with comments including “they’ve always kept me informed” and “the dentist goes through all the options with me and I get a detailed estimate in advance”.

People were involved in the planning of their treatment, and medical history and consent were obtained prior to the start of their treatment. People we spoke with were very satisfied with the level of care they had received. People commented “the dentist takes the time to help me with the extra care I need” and “absolutely brilliant, I’m very happy.”

Appropriate safeguarding procedures were in place to help protect people from the risk of abuse. Staff were trained and supported to an appropriate standard, and there were sufficient quality assurance checks to ensure a good level of care was provided.