We carried out a desk based review on 24 November 2015 to check whether the practice had taken action to address a breach of Regulation 12(2)(h) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Background

Melbourn Dental Practice provides primary dental care and treatment to patients whose care is funded through the NHS and to patients who pay privately. The service is led by a principal dentist (also the registered manager) and two associate dentists, three registered dental nurses and a trainee dental nurse. A registered manager is a person who is registered with the Care Quality Commission to manage the service. They 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 manager is also a registered dental nurse and dental health educator. They are supported by a receptionist.

We reviewed the action plan, spoke with the practice manager and requested updated evidence of the actions taken. We found the practice had taken the appropriate action.  

Our key findings were:

• The practice had made suitable improvements to the environmental cleaning procedures and to the hand wash sinks in the treatment room.

The inspection took place on 14 January 2015 as part of our national programme of comprehensive inspections. We had previously inspected the service in 2012 when the provider was found to be meeting all five of the standards assessed.

Melbourn Dental Practice provides primary dental care and treatment to patients whose care is funded through the NHS and to patients who pay privately. The service is led by a principal dentist (also the registered manager) and two associate dentists, three registered dental nurses and a trainee dental nurse. A registered manager is a person who is registered with the Care Quality Commission to manage the service. They 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 manager is also a registered dental nurse and dental health educator. They are supported by a receptionist.

Prior to our inspection we left some CQC comment cards for patients to complete about their experience of the practice. A total of 109 comments cards were received and we found that patients had made positive comments about the practice and were very satisfied with the care and treatment they received from the staff. Patients who said they were particularly nervous about visiting the dentist told us staff treated them with compassion and put them at ease. We spoke with four patients on the day of the inspection who also said that staff were kind and caring, explained about their care and treatment options and gave them valued advice about their dental health.

Our key findings were:

• The practice had effective systems in place to ensure the safety of equipment (including X-ray equipment), staff recruitment and for identifying and managing patient safety incidents. Staff managed the decontamination of dental instruments in line with published guidance. However improvements were required to strengthen environmental cleaning procedures and to ensure that emergency medicines were always available.

• Patients were given appropriate levels of information and involved in decisions about their treatment. Clinical records were well maintained and patients were referred for specialist treatment in a timely and efficient manner. Staff received appropriate training to meet the needs of patients.

• We received a large amount of comments cards from patients and spoke with others who gave very positive feedback about the caring and professional service they received from staff.

• The practice provided a range of services that met the needs of their registered patients and were able to provide us with examples of how they had made changes to suit individual needs.

• The practice had a clear leadership structure and a learning culture was embedded. Risks were monitored and well managed. Regular audits were completed to ensure a continuous cycle of improvement.

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

• Review and document the environmental cleaning procedures so they are in line with national guidelines.
• Ensure that all hand wash sinks in the treatment rooms meet HTM 01-05 guidelines for the prevention and control of infection.

You can see full details of the regulations not being met at the end of this report

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

• Ensure that any concerns or complaints received are recorded and monitored in line with the practice complaints policy.
• Improve staff training records held at the practice so that the provider has a clear record of planned and completed training for all team members.
• Ensure that appropriate emergency medicines are stocked and available for use at all times.

Six people we spoke with during our inspection on 23 November 2012 told us they were satisfied with their care and treatment and that they had always been treated with respect and spoken to politely by staff and their dentist. One person said the practice was, "Top notch. They are very efficient and they always ask me about my medication".

The practice had appropriate arrangements in place that ensured children and vulnerable adults were safeguarded from the risk of abuse.

Infection Control procedures and processes the practice had in place were efficient and carefully applied to reduce identified risk of cross infection between people.

The premises were comfortable, clean and well maintained. The practice was at ground floor level and there was suitable and easy access for people who used a wheelchair.