We carried out an announced comprehensive inspection of this practice on 7 July 2015. During this inspection we found breaches of legal requirements in relation to the Health and Social Care Act 2008. After this comprehensive inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to Regulation 12- Safe care and treatment, and Regulation 17-Good Governance.

We undertook this focused inspection to check that the practice had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Newmarket Dental Surgery on our website at www.cqc.org.uk

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

Key findings

• Overall we found that sufficient action had been taken to address the shortfalls identified at our previous inspection and the provider was now compliant with the regulations.

The practice provides both NHS and private dental treatment to patients of all ages. It employs two full-time dentists, one part-time orthodontist and one part-time dental hygienist. They are supported by three dental nurses and three receptionists.

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.

The practice is located in the basement of a large listed building, and access is down steep stone steps. It has three treatment rooms, a small staff kitchen area and one decontamination room for cleaning, sterilising and packing dental instruments.

We carried out an announced comprehensive inspection on 7 July 2015 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 not 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 not providing well-led care in accordance with the relevant regulations

We carried out a comprehensive inspection of Newmarket Dental Surgery on 7 July 2015. The practice provides both NHS and private dental treatment to patients of all ages. It employs two full-time dentists, one part-time orthodontist and one part-time dental hygienist. They are supported by three dental nurses and three receptionists.

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.

The practice is located in the basement of a large listed building, and access is down steep stone steps. It has three treatment rooms, a small staff kitchen area and one decontamination room for cleaning, sterilising and packing dental instruments.

We spoke with three patients during our inspection and also received 48 comments cards that had been completed by patients prior to our inspection. We received many positive comments about the cleanliness of the premises, the empathy and responsive of staff and the quality of treatment provided. Four people told us that staff understood their nervousness about dental treatment and dealt with it well. Some patients told us that staff worked well with their children. Patients also appreciated the text service offered, which helped remind them of their appointments

However two people commented that although the service they received was good, they were not always clear about the costs involved in their treatment particularly around charges for the hygienist. Two patients told us that getting an appointment with the orthodontist was difficult, and they often had to wait many weeks, before one became available. One patient found the environment of the practice depressing, with little natural light.

Our key findings were:

• 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 assessing risks to staff and patients.

• Staff had received training appropriate to their roles and were supported in their continued professional development.

• There were sufficient numbers of staff to meet patients’ needs.

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

• The practice sought feedback from staff and patients and used it to improve the service provided.

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

• take appropriate action if there is a clinical or medical emergency by having suitable equipment in place to manage the more common medical emergencies encountered in general dental practice.

• have systems and processes in place to identify risk to health, safety and welfare of people who use services by ensuring the practice’s policies are kept up to date; that significant events and incidents are analysed, and that dental care records reflect patients’ consent and decisions in relation to their treatment.

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:

• Appoint a safeguarding lead within the practice and ensure that all staff are aware of who this is.

• Ensure all dental staff have regard to NHS England’s publication for Delivering Better Oral Health- an evidence based toolkit to support dental practices in improving their patients’ oral and general health.

• Review the practice’s arrangements for the audit of infection control procedures, the monitoring of autoclave cycles and the storage of loose items in treatment room drawers.

• Ensure that all dental care records are completed to the same high standard across the practice.

• Ensure that notes from staff employment interviews are recorded to evidence they are undertaken in line with good employment practice.