We carried out an announced comprehensive inspection on 29 November 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

IDH Bury St Edmunds provides mostly NHS and some private treatment to children and adults. It serves about 21,000 patients and is part of IDH Limited which has a large number of dental practices across the UK.

The practice employs eight dentists, eight dental nurses, two dental hygienists and three reception staff. A full time practice manager 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 is situated in a converted residential property and has eight dental treatment rooms, one decontamination room, two waiting rooms and a large staff room.

Our key findings were:

• Staff understood and fulfilled their responsibilities to raise and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• Premises and equipment were visibly clean, secure, properly maintained and kept in accordance with current legislation and guidance.

• There were sufficient numbers of suitably qualified and competent staff. Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• The practice took into account any comments, concerns or complaints and used these to help them improve the service.

• Staff felt well supported and were committed to providing a quality service to their patients.

• The practice had strong clinical and managerial leadership and governance arrangements in place.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

We found that dental care was provided according to people's assessed needs and that people signed consent and treatment records to show they understood and consented to treatment. The dentist spoke with people using the service prior to treatment to check if there were any changes in their medical condition from the previous treatment and to agree the treatment to be provided.

We spoke with five people who told us they were happy with the service. A parent told us, “I bring my children here because I am confident with the dentist.”

The service was provided on three floors and the ground floor had surgery that could accommodate anyone unable to use the stairs. The practice manager informed us the service operated a later evening service on Mondays.

We spoke with four staff who told us about how consent for treatment was obtained and medical records were stored and up dated for each treatment on the computer system.

We spoke with four staff and they were all aware from their training of the safeguarding procedure for children and vulnerable adults. There was a complaints procedure in place along with surveys and a suggestion box available in reception. The service supported its staff through training, supervision and an appraisal system.

We found all staff mandatory training was up to date.