We carried out an announced comprehensive inspection on 20 October 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 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

Oak Dental Care-Ormskirk offers mainly private dental care services to patients of all ages. The practice has a small NHS contract including services to children. The services provided include preventative advice and treatment and routine and restorative dental care. The practice has six treatment rooms, two waiting areas and a decontamination room. Treatment and waiting rooms are on the ground and first floor of the premises.

The practice has four dentists, a hygienist, six qualified dental nurses and a dental nurse trainee; in addition there were two receptionists. The practice is one of four within the Oak dental Care Limited organisation. A lead nurse is responsible for managing staff training and staff rotas and for infection control procedures and audits across all practices. The principal dentist and provider for the Oak dental care Limited Group is the registered manager for each of the practices. 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 open on Monday, Wednesday and Thursday from 9.00am until 5.00pm, Tuesday from 9.00am until 7.00pm and Friday from 9.00am until 4.30pm. Saturday morning appointments are available one Saturday each month in conjunction with another practice in the Oak Dental Care Group.

We viewed 45 CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. In addition we spoke with three patients on the day of our inspection. We reviewed patient feedback gathered by the practice over the last 12 months. Feedback from patients was overwhelmingly positive about the care they received from the practice. They commented staff were caring and respectful and that they had confidence in the dental services provided. Patients told us that staff put them at ease and listened to their concerns.

Our key findings were:

• There were systems in place to help ensure the safety of staff and patients. These included maintaining the required standards of infection prevention and control and responding to medical emergencies

• The practice carried out oral health assessments and planned treatment in line with current best practice guidance, for example from the Faculty of General Dental Practice (FGDP). Patient dental care records were detailed and showed on-going monitoring of patients’ oral health.

• Patients commented they felt involved in their treatment and that it was fully explained to them. We reviewed 45 CQC comment cards that had been completed by patients. Common themes were patients felt they received very good care in a clean environment from a helpful practice team.

• Patients were able to make routine and emergency appointments when needed. There were clear instructions for patients regarding out of hours care.

• There were defined leadership roles within the practice and there was a range of clinical and non-clinical audits undertaken to monitor the quality of the service.

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

• Implement a process to assure compliance with the annual monitoring of the quality of the water supply.

• Review how documentation relating to policies and procedures are maintained; in order to ensure they are up to date and easily accessible to staff in the practice.

• Review how the actions arising from audits are recorded to evidence changes made and provide assurance that changes are implemented in a timely manner.
• Review the process in place regarding the storage and dispensing of high fluoride toothpaste, having due regard to current guidelines.

People told us they were very satisfied with the care and treatment provided at Oak Dental Care Limited. They had been involved in their treatment plan and discussed their options before their treatment started.

People undergoing treatment told us, they found the staff to be friendly and reported that they were treated with respect and their privacy was maintained at all times. People commented,"With any treatment plan it is always fully explained to me what will happen next, what to look for. I always used to think a dentist was just about teeth, I always get a full mouth assessment prior to my teeth being looked at".

We were also told the environment was clean and tidy, "The surgery is always clean, all the staff wear gloves and masks when I'm having treatment".

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive or to ensure the provision of safe and appropriate care at all times.