We carried out an unannounced focussed inspection on 29 September 2016 to ask the practice the following key questions; are services safe and well-led? We conducted this unannounced inspection following concerns received about incident management within the practice.

Our findings were:

Are services safe?

We found that this practice was providing safe 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

Barrow Mint Dental Practice is situated in the centre of Barrow. The dental practice has been owned by Dr Julie Forde since 1997. Dr Forde is supported by six dentists, six dental nurses, four trainee dental nurses and an acting practice manager. There are seven treatment rooms situated within the practice with three rooms on the ground floor and the rest accessible by stairs only. The practice treats people of all ages and provides a wide range of NHS and private dental services.

The opening times are Monday to Friday 8.30am to 5.00pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person.

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.

Our key findings were:

• Staff had received safeguarding training and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, emergency medicines and appropriate equipment was available.
• The practice’s infection control procedures and protocols were suitable giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: 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’, but there was some issues with ‘high level’ cleanliness in the treatment rooms.
• The premises were secure and there was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• The practice gathered the views of patients and took into account patient feedback.
• Staff were supervised, felt involved and worked as a team.
• Governance arrangements were in place for the smooth running of the practice and for the delivery of high quality person centred care.
• Audits of various aspects of the service, such as radiography and dental care records were undertaken at regular intervals to help improve the quality of service. However, audits did not have documented learning points and the resulting improvements demonstrated.
• There had been a breakdown in the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: 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.
• Review its audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.

People we spoke with confirmed that the dentists and dental nurses always explained what they were going to do. We saw staff speaking with people in a respectful manner and staff we spoke with understood the requirements for privacy, dignity and confidentiality. People told us that they were "very happy" with the level of information they had received. We found that people were able to express their views and were involved in making decisions about their care and treatment. There was also strong agreement that staff were “very friendly”. One person told us; “I receive a very prompt and a very efficient service. They (staff) have a nice manner and always happy to help.”

The practice had appropriate equipment to support people in the event of an emergency. The practice facilities were clean and well maintained with appropriate floor and surface coverings. We found that staff received appropriate professional development and were able to obtain further qualifications. Staff confirmed they had on-going formal appraisal. We found that the practice had an effective system in place to handle complaints and we saw these were actioned appropriately and within an agreed timescale.