We carried out an announced comprehensive inspection on 4 October 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

Northgate Dental Practice is situated in Cleckheaton, West Yorkshire. It offers mainly NHS dental treatment to patients of all ages but also offers private dental treatments. The services include preventative advice and treatment and routine restorative dental care.

The practice has four surgeries, a decontamination room, a waiting area and a reception area. All of the facilities are on the ground floor of the premises. There are accessible toilet facilities.

There are five dentists (one of whom is currently on maternity leave), six dental nurses (one of whom is currently on maternity leave) and a practice manager.

The opening hours are Monday from 8-50am to 5-00pm, Tuesday, Thursday and Friday from 8-30am to 5-00pm and Wednesday from 9-00am to 5-00pm.

The principal dentist 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.

During the inspection received feedback from 50 patients. The patients were positive about the care and treatment they received at the practice. Comments included staff were pleasant, helpful and caring. Patients also commented that the practice was clean and hygienic, their needs were responded to and they received the right care and treatment.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed that treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed that patients were treated with kindness and respect by staff.
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• Patients were able to make routine and emergency appointments when needed.
• The governance systems were effective.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions.
• Instruments were sterilised in line with guidance in ‘Health Technical Memorandum 01-05 -Decontamination in primary care dental practices’. We found some inconsistencies in the awareness of staff in the manual scrubbing of instruments.

• Medical emergency medicines and equipment were in line with guidance from the British National Formulary and the Resuscitation Council UK. We noted that the automated external defibrillator and emergency oxygen cylinder were only checked on a monthly basis.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the practice’s protocols for the checking of the automated external defibrillator and emergency oxygen cylinder.
• Review staff awareness of the practice’s infection control procedures and protocols with regards to the manual scrubbing of instruments.
• Review its X-ray audit protocols to ensure that the audits are practitioner specific.

We observed staff treating people with respect, being polite and courteous. People told us they were happy with the care provided and were involved with their care and treatment needs. People we spoke with told us their dignity was respected and confidentiality was always maintained. One person told us, “I have enough information to make a decision about my treatment.” Another person told us, “We discuss preventative treatments.”

People had thorough, detailed care and treatment plans relating to all aspects of their care needs. They contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. We spoke with three people who used the service who told us they were happy with the care and treatment they received. One person told us, “Never any problems, I am quite happy.” Another person told us, “I have no issues after 11 years. Care is good and I have had good experiences especially with my son.”

We observed people were treated in a clean, hygienic environment. There were effective systems in place to reduce the risk and spread of infection. The people we spoke with told us they had no concerns with the cleanliness of the practice. One person we spoke with told us, “It’s really clean.” Another person told us, “It is always clean and tidy. It never smells.”

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work.

There were quality monitoring programmes in place, which included people giving feedback about their care and treatment. This provided an overview of the quality of the service’s provided.