We carried out an announced comprehensive inspection on 3 September 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

Revive Dental Practice was registered with the Care Quality Commission (CQC) in July 2011. This was to provide dental services to patients in the Chaddesden area of Derby and the surrounding areas in the county of Derbyshire. The practice provides mostly NHS dental treatment (approximately 95%). The dental practice is owned by Roderick's Limited, a corporate provider with 56 registered locations. Services provided include general dentistry, dental hygiene, cosmetic dentistry and dental implants.

The practice is located on the first floor of a purpose built health centre. Access to the practice is either by stairs or a passenger lift. The practice is open Monday to Friday 8:30 am to 5:30 pm, Tuesdays 8:30 am to 7:00 pm and alternate Saturday mornings 9:00 am to 1:00 pm.

The practice has three dentists, two dental nurses and four trainee dental nurses. All six dental nurses also worked on reception. The practice had a practice manager. One dental nurse was registered with the General Dental Council. One was newly qualified and awaiting their registration documentation and the other four were trainee dental nurses.

A representative of the provider 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 10 Care Quality Commission (CQC) comment cards that had been completed by patients, about the services provided. We saw that all 10 comment cards had wholly positive comments. Patients said they received a good service and the staff were friendly, professional and competent. In addition, we spoke with two patients who also said they were happy with the dental service they were receiving. Patients said they were treated well at the practice, and were able to ask questions. Both patients said their dentist explained the treatment options and costs.

Our key findings were:

• The practice had systems and procedures for recording accidents, significant events and complaints. Learning from complaints and significant incidents were recorded and learning was shared with staff.
• The practice had provided training in safeguarding and whistle blowing for all staff during 2015, and staff were aware of these procedures and the actions required.
• The practice had a high turnover of dental nurses due to promotion which had led to inconsistency when working with dentists. This also meant that the majority of dental nurses were quite inexperienced.
• Staff had been trained to deal with medical emergencies.
• There was a strong team ethos, and staff were encouraged to contribute towards training and sharing their knowledge.
• The practice engaged in health promotion initiatives, to encourage patients to have good oral health.
• Emergency medicines and life-saving equipment were readily available.
• There were robust recruitment procedures in place for new staff.
• 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.
• Feedback from patients was positive about the services on offer, and the staff working at the practice.
• Patients were involved in decision making, options were identified and patients had the opportunity to ask questions.
• Patients’ confidentiality was maintained.
• The practice sought regular feedback from staff and patients about the services they received.

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

• Stock sufficient quantities of equipment to safely meet patients’ needs: -particularly in relation to rubber dam kits.
• Review policies, procedures and risk assessments are all dated to identify that they are current and up-to-date.
• Clearly identify emergency cut-off switches for the X-ray machines in all treatment rooms.

People we spoke with told us they were involved in decisions about their care and treatment options. This was confirmed by our observations on the day. People told us the staff were friendly and treated them with dignity and respect. One person told us "The staff are friendly. They have dealt with me well this morning by getting me an emergency appointment within an hour of calling".

People told us they felt the practice delivered care and treatment in a way that met their needs and felt safe when they had treatment. One person told us "The practice is well presented. I don't come here myself but have brought my grandson and the dentist was great with him".

Staff could give us examples of types of abuse and possible signs of abuse. They were also aware of the reporting procedure for safeguarding issues.

We saw that there were effective systems in place to reduce the risk and spread of infection.

The provider has effective recruitment and selection procedures in place and carries out relevant checks when they employ staff.

The provider had clear systems in place to obtain feedback from all persons involved in the service as well as auditing their own service