We carried out an announced comprehensive inspection on 6 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

Parkfield Dental, Berrow Health Campus is located in the coastal town of Burnham-on-Sea, Somerset. The practice is purpose built and provides primary dental care services for people who require dental procedures. The practice provides mostly NHS care with some private treatments. There are three dental surgeries all situated on the ground floor. There is level access from the street and parking, including parking for disabled patients at the practice. Approximately 5,000 patients are registered at the practice.

The staff structure of the practice consists of three dentists, one dentist in their foundation year after qualifying as a dentist and a dental hygienist. There is a practice manager, three dental nurses, one trainee dental nurse and two receptionists. Dental nurses also act as reception staff. The practice is a training practice for dentists in their foundation years after graduating.

The practice is open from Monday to Friday from 8.30am to 5.00pm (with extended opening until 7.00pm on Mondays, Tuesdays and Wednesdays). There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The registered manager is the company manager who works as a dentist in one of the other company locations in Somerset. 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 inspection took place over one day and was carried out by a CQC inspector and a specialist dental advisor.

Fourteen patients provided feedback directly to CQC about the service. All were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• There were effective systems in place to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment text/phone reminders were available on request up to one week prior to appointments.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke with felt supported by the practice manager and were committed to providing a quality service to their patients.

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

• Clarify and formalise clinical leadership roles at the practice.
• Improve staff meeting record keeping and circulate meeting minutes to the whole staff team.
• Implement a system for the recording of prescriptions issued to patients.
• Implement a system for the formal analysis of clinical audits.

During our inspection we spoke with four people who used the service, two out of the three practising dentists, the hygienist and one dental nurse. People told us “this is the best dentist I have ever been to” and “I do not fear coming to the dentist anymore”.

We looked at three treatment records of people who used the service. These showed what was discussed with the person and what treatment they had consented to and opportunities to think about their options before deciding on treatment.

The practice had procedures in place to deal with medical emergencies and had taken action to ensure people’s rights were protected when making decisions on their behalf. Staff had knowledge of what their role was in protecting vulnerable adults and children. Staff also felt well supported and completed relevant training in their role. The practice had procedures in place to reduce the risk of cross infection and decontamination.