We carried out an announced comprehensive inspection on 10 January 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

Whitecross Dental, Church Road, Doncaster is situated on the main road in Stainforth and is part of the Mydentist group. The practice is a two story converted house providing mainly NHS and private treatment to patients of all ages. It comprises two treatment rooms; one on each floor, a decontamination room for sterilising instruments, a reception/waiting area, a staff room/kitchen and a general office.

Access for wheelchair users and pushchairs is possible by a step free entrance, which leads into the reception and waiting area. Car parking is available close by on the main road.

The dental team is comprised of one dentist (one dentist is currently being recruited), a practice manager, four dental nurses and one receptionist.

The practice is open:

Monday to Friday 8:30am to 5:30pm

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.

On the day of inspection we spoke with one dentist, two dental nurses, one receptionist and the practice manager. The area manager and regulatory officer were also present for the inspection. We were told by the area manager that recent staffing problems had become a priority and recruitment of a second dentist was in hand.

We received 17 CQC comment cards providing varied feedback. Some patients who provided feedback were very positive about the care and attention to treatment they received at the practice. Patients commented they were involved in all aspects of their care and found the staff to be caring, reassuring and helpful. Patients commented that there was sometimes a long delay from the time of their appointment to actually seeing the dentist and others commented that dentist appeared not to stay long at this practice. Patients stated staff were good at communicating information, they could access emergency care easily and they were treated with dignity and respect.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• The practice was visibly clean and tidy.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had systems in place to work closely and share information with the local safeguarding team.
• The practice was reviewing its staff numbers and availability.
• Infection control procedures were in accordance with the published guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Treatment was well planned and provided in line with current best practice guidelines.
• 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 patients’ needs.
• The practice had undertaken a governance review, put remedial actions into place and further improvements were being addressed.
• The practice sought feedback from staff and patients about the services they provided.
• There were newly defined leadership roles within the practice and staff felt supported at all levels.

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

• Review the practice’s Medicines and Healthcare Products Regulatory Authority (MHRA) reporting procedure and embed the process within the practice.
• Review the practice audit processes to monitor and track the use of prescription pads.
• Review the practice’s knowledge on the principles of the Mental Capacity Act 2005(MCA) and the concept of Gillick competence and provide refresher training for all staff.
• Review the practice’s procedure for carrying out X-ray audits annually to meet the requirements of the National Radiological Protection Board (NRPB) guidance and IR(ME)R 2000 regulations.

We did not speak with people who used the service as this inspection was concerned with whether the provider had in place effective systems for the cleaning and decontamination of dental instuments.

We found that people were protected from the risk of infection because effective systems were in place to reduce the risk and spread of infection, and appropriate guidance had been followed. This was because the provider had in place effective systems for the cleaning and decontamination of dental instruments.

People who used the service told us they were asked to consent to treatment after a full explanation of the proposed procedures had been given to them. We found that the practice had appropriate policies on consent which were understood and followed by staff.

People told us they were satisfied with the care they received. They also told us they were given the fullest information about the procedures being undertaken. We found that people’s needs were assessed and treatment was planned and delivered in line with their individual treatment plan.

We found that people were not protected from the risk of infection because effective systems were not in place to reduce the risk and spread of infection, and appropriate guidance had not been followed. However, people told us they were treated in a clean environment.

People told us staff seemed competent in their job and knew what they were doing. We found that staff received an appropriate level of training and professional development.

People who used the service told us they would know how to make a complaint and who to complain to. There was a complaints procedure in place and staff were aware of their responsibilities to report complaints so they could be formally investigated.