We carried out an announced comprehensive inspection on 14 March 2016 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

Riversdale Dental Practice is a private dental practice that provides dental services for approximately 1,500 patients in the Gainsborough area of Lincolnshire. The practice is situated close to the town centre with parking available on the street outside. The practice is in a building that has been adapted for the purpose of dentistry and has a waiting room in the reception area and two treatment rooms. The waiting area has sofas and four high back chairs with arm rests to enable ease of use for those with limited mobility. There are two treatment rooms on the ground floor although only one is used as a treatment room, the other is used as a decontamination room. There is a toilet that the public are able to use however it is on the first floor and would not be accessible to those patients in a wheelchair or those with limited mobility. Other areas that are used on the upper floors are for staff only. The building is accessed from the street and there is a ramp and handrail to the main entrance to enable patients with limited mobility, wheelchair access, or pushchairs access to the practice.

Two dentists work part time alongside a full time dental nurse and a full time receptionist.

The principal dentist is the owner and registered manager of the practice. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered dentists, 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 provides private dental treatment to adults and children. The practice is open Monday to Friday from 9am and closes at 5pm other than Wednesday when it closes at 1pm. The practice closes for lunch from 1pm until 2pm.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 47 patients about the services provided. The feedback reflected highly positive comments about the staff and the services provided. Patients commented that the practice was clean and hygienic and that it was caring and friendly. They said that they found the staff offered an efficient and professional service. They said that staff were caring, helpful and friendly. Patients said that explanations about their treatment were clear and that they were given time to ask questions. Much of the feedback was in relation to patients who were nervous and they commented how the staff were understanding and patient; they were made to feel at ease.

Our key findings were:

• There was a process in place for reporting and learning from incidents, accidents and near misses.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in place and staff had access to personal protective equipment.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks.
• Patients were treated with dignity, respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum where possible.
• The practice was well-led and staff felt involved and worked as a team.
• Staff had been trained to deal with medical emergencies.
• Policies and procedures were in place to provide and manage the service.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• All staff were clear of their roles and responsibilities.

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

• Review availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance and conduct documented infection control audits every six months.
• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review policies and procedures annually to make sure information is relevant and up to date.

We used a number of methods to help us reach a judgement on this practice. These included talking with three patients, two dentists, and a dental nurse. We also looked at a range of records, organisational policies and procedures. These included a sample of patient treatment records, records of meetings and patient surveys and audits undertaken to assess the quality of the service provided.

Patients we spoke with told us they were involved in decisions about their treatment and were satisfied with the service they received. Also that, the dentists and surgery staff were polite and treated them with respect, treatment was delivered safely and the practice was clean and hygienic.

One patient told us, “I have attended this surgery for many years and have always been completely satisfied with the treatment and service I have received.” Another told us “I have always found the dentist and reception staff pleasant and professional.”

We observed staff interacting with patients in a courteous, polite and professional manner.

All of the patients we spoke with told us they felt safe visiting the practice and when receiving treatment and felt comfortable about raising any concerns they might have.

The practice had a clear infection control policy which staff were aware of and knew how it should be implemented. Staff were encouraged to develop their skills and undertake appropriate training and personal development to deliver safe and effective treatment for patients.