We carried out an announced comprehensive inspection on 28 February 2017 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 Maghull is located within a ground floor premises. The premises comprise of five treatment rooms, reception and waiting area, decontamination room, office and staff facilities. There are no steps at the practice and it is accessible to patients with disabilities, impaired mobility and to wheelchair users. Parking is available on the nearby streets.

The practice provides general dental treatment to patients predominantly on an NHS basis but also on a private basis. The opening times are:

Monday – Friday 8.30am – 1pm and 2pm – 5pm

The practice is staffed by two dentists, two dental therapists, five dental nurses, one of whom is a trainee, a receptionist and a lead nurse who also acts as a practice manager.

The principal dentist of the organisation 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 piloting the new NHS dental contract prototype. The prototype new approach has three key elements; It provides guidance on care (the pathway), measures the quality of the care delivered (a quality and outcomes framework) and, in the next prototype stage, will remunerate in a way that supports continuing care and prevention as well as activity.

We received feedback from 36 people during the inspection about the services provided. Patients were positive about all aspects of the care and treatment. Patients commented that they found the practice provided an excellent service and that staff were friendly, helpful and approachable. They said that they were always given helpful information about dental treatment and that the clinicians listened to them and were accommodating. Patients commented that the practice was clean and comfortable. Care, support and reassurance were given to nervous or anxious patients. Children were treated with care and felt comfortable and happy at the dentist. Emergency appointments were always available.

Our key findings were:

• The practice had procedures in place to record accidents and incidents; however significant events were not always recorded and analysed fully or reviewed annually to identify themes and trends.
• Staff demonstrated knowledge and awareness of safeguarding, had received appropriate training, and they knew the processes to follow to raise concerns. Safeguarding policies and procedures were in need of updating to reflect relevant legislation and guidance.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients. Improvements were needed to the recruitment process to ensure all required information was held in respect of people employed at the practice.
• Staff followed current infection control guidelines for decontaminating and sterilising instruments. Improvements were needed to ensure risk assessments for infection control, such as Legionella and use of sharps were up to date and followed relevant guidance and legislation.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available and checked for working order and expiry dates.
• Governance arrangements were in place for the smooth running of the practice. Most of these were operating effectively. Some policies and procedures were in need of review and updating and some of the risk assessments were not up to date.

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

• Review the significant event policy and procedures to include identification and analysis of significant events and untoward clinical incidents. Review significant events and complaints on a regular basis to identify themes and trends.
• Review the system for dealing with patient safety alerts and notices to include documenting actions taken appropriately.
• Review the protocol for maintaining accurate, complete and detailed records relating to employment of staff. This includes ensuring recruitment checks, including references, are carried out and recorded.
• Review the storage arrangements of clinical waste waiting to be collected outside the building.
• Review policies and procedures, ensuring they are up to date and in line with current legislation and guidance, include an issue and review date on them. Make sure staff are familiar with them and how to access them.
• Review the general and health and safety risk assessments to ensure they are up to date and reflect current situations including general environmental, Legionella and infection control risk assessments.
• Review the safer sharps policy and risk assessments to include consideration of implementing a safer sharps system.

We spoke with people using this service on the day of our visit. They told us that they were pleased with the care and treatment. The staff were friendly and treated them with respect and they felt that there was good information available.

They told us the clinic was clean and easy to access and that their privacy was maintained.