We carried out an announced comprehensive inspection on 11 January 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

Orange Tree Dental Practice is located in Driffield and provides private treatment to patients of all ages and has four treatment rooms.

Wheelchair users or pushchairs can access the practice through step free access at the rear of the practice. Car parking spaces are available near the practice.

The dental team is comprised of four dentists (three principal dentists and an associate dentist), six dental nurses (one of which is a trainee), a dental hygienist, a dental hygiene and therapist and a receptionist. The practice has a dedicated room with X-ray machines including an Orthopantomogram (OPG), a decontamination room for sterilising dental instruments, a staff room/kitchen and a general office.

On the day of inspection we received 49 CQC comment cards providing positive feedback. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They felt involved in all aspects of their care and found staff to be caring, compassionate, friendly and the treatment to be fantastic. They mentioned staff had good communication skills, were efficient and they were treated with dignity and respect in a clean and tidy environment. Patients also commented they could access emergency care easily.

The practice is open:

Monday, Tuesday, Thursday and Friday 8:30am – 5:30pm.

Wednesday 7am – 7pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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.

Our key findings were:

• The practice appeared clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• Staff had been trained to handle medical emergencies. Appropriate medicines and life-saving equipment were readily available and in accordance with current guidelines.
• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• Staff understood and received safeguarding training and knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Safe recruitment of staff was in place.
• Treatment was well planned and provided in line with current guidelines.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The practice sought feedback from staff and patients about the services they provided.
• Complaints were responded to in an efficient and responsive manner.

We found areas of notable practice. Staff induction included documents explaining the use of all equipment within the practice, all policies, protocols and risk assessments. At the end of the induction training a questionnaire would be given to ensure evidence based learning and understanding was in place for each staff member. This was evident when talking to staff; each member had extensive knowledge of the practice policies, procedures and current guidance and regulations. Monthly meetings were structured to involve learning either through in house training sessions led by the staff or by external learning sessions.

The staff worked very well as a team, supported each other and new team members to ensure the practice ethos was followed throughout. Each month there was a policy of the month to review so all staff kept up to date with changes in current guidance and regulation.

We found that patients that used the practice only received treatment after giving their consent and were satisfied with the care and treatment they received. They said, “I know I signed forms when I joined the practice” and “The dentists look after not just me, but my whole family very well”.

Patients were protected against the risks of harm or abuse because the provider had systems in place to detect and report any suspicious or actual incidents of abuse and staff had completed Criminal Records Bureau security checks.

Patients were protected from the risk of infection because there were effective infection control measures and practices in place, staff were appropriately trained and supervised and there was a quality monitoring system in operation that listened to patients’ views and acted on them.