We carried out an announced comprehensive inspection on 12 August 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

Oswald House Dental Practice was registered with the Care Quality Commission (CQC) in November 2013 to provide dental services to patients in Ashbourne and the surrounding areas in the county of Derbyshire. The practice provides both NHS and private dental treatment, with approximately 60% being NHS patients. Services provided include general dentistry, dental hygiene, teeth whitening, crowns and bridges, and root canal treatment. The practice is situated in a Grade II listed building in the centre of Ashbourne, with treatment rooms on the ground and first floors. The practice is open Monday to Friday 8:45 am to 12:45 pm and 1:45 pm to 5:30 pm. Access for urgent treatment outside of opening hours is usually through the NHS 111 telephone line. In addition a private out-of-hours service is available for a £95 call out fee plus the cost of treatment. The practice is considering whether a relocation to new purpose built premises would be in the practices and patients’ best interests.

The practice has four dentists, two hygienists/ therapists, and seven dental nurses. There is a practice manager, a reception manager and three receptionists.

The practice manager 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.

We viewed nine Care Quality Commission (CQC) comment cards that had been completed by patients, about the services provided. We saw that all nine comment cards had wholly positive comments. Patients said they were extremely happy with the service provided. In addition, we spoke with two patients who spoke positively about the dental service they were receiving. Patients said they were treated well at the practice. Patients said they were able to ask questions, and the dentist explained the treatment options and costs.

Our key findings were:

• The practice had systems for recording accidents, significant events and complaints.
• Learning from any complaints and significant incidents were recorded and learning was shared with staff.
• The practice was visibly clean.
• The practice had provided training in safeguarding and whistle blowing for all staff, and staff were aware of these procedures and the actions required.
• Patients said they were satisfied with the service they received, and several said they were very happy.
• Patients said they were treated with dignity and respect.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies.
• Emergency medicines and oxygen were readily available.
• The practice had ordered an automated external defibrillator (AED). An AED is a portable electronic device that automatically diagnoses life threatening irregularities of the heart and delivers an electrical shock to attempt to restore a normal heart rhythm.
• The practice followed the relevant guidance (Department of Health's guidance, ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Patients’ care and treatment was planned and delivered in line with National Institute for Health and Care Excellence (NICE) guidelines.
• Patients were involved in making decisions about their treatment, and options were identified and explored with them.
• Patients’ confidentiality was maintained.

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

• Ensure staff training records identify that all staff had received up-to-date fire training. This posed a risk to patients and staff, as the dental practice was located in an older building over several floors.
• Ensure the infection control policy gives full guidance to staff regarding infection control risks and management of those risks.
• Ensure sharps boxes have guidance on display beside the box, as identified in health and safety executive (HSE) guidance: ‘Health and safety (sharp instruments in healthcare) regulations 2013.
• Ensure the clinical waste bin in the decontamination room has a lid, to reduce the infection control risk.
• Ensure records of measures taken to reduce the risk of patients and staff developing Legionnaires' disease are complete and up-to-date.
• Ensure information on how to make a complaint is clearly displayed in the practice leaflet.