We carried out an announced comprehensive inspection on 30 March 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

No.1 Nursery Road Dental Practice is a dental practice providing general dental services on a private basis. The service is provided by two dentists. They are supported by two dental nurses (one of whom was on maternity leave at the time of our inspection). Both of the dentists worked part-time at the practice and one was available to assist with dental nursing duties in the absence of the staff member on maternity leave.

The practice is located near a busy High Street in a commercial area. There is wheelchair access to the practice and a car parking bay for patients with disabilities. The premises consist of a waiting room, two treatment rooms and toilet facilities on the ground floor. The first floor comprises two decontamination rooms used for the cleaning and sterilisation of used dental instruments, an X-ray room, a staff room, an office and toilet facilities. Opening hours are from 9am to 5:30pm on Monday to Friday.

The two practice owners are registered with the Care Quality Commission (CQC) as a partnership. Like individual 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.

Twenty-nine patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with three patients. Overall the information from patients was complimentary. Patients were positive about their experience and they commented that staff were helpful, friendly and professional.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding and the management of medical emergencies. We identified some areas for improvement and we were told these would be actioned promptly.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation; however, the dental care records were not sufficiently detailed to record this.
• Staff received training appropriate to their roles.
• Patients told us they found the staff helpful and friendly. Patients commented they felt involved in their treatment and that it was fully explained to them.
• Patients were able to make routine and emergency appointments when needed.
• The practice had an effective complaints process in place and the practice was able to demonstrate they made improvements as a direct result of patient feedback.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping. However, learning points and action plans were not always documented.

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

• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal references taken and ensuring recruitment checks, including references, are suitably obtained and recorded. All staff appraisals should be documented.
• Review the practice’s audit protocols for various aspects of the service, such as dental care records, at regular intervals to help improve the quality of service. The practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.