We carried out an announced comprehensive inspection on 31 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

Sandon Dental Practice is a dental practice providing general dental services on a NHS and private basis. The service is provided by three dentists (one of whom is the provider). They are supported by four dental nurses (one of whom is a trainee) and a practice manager. The dental nurses also carry out reception duties.

The practice is located on a main road near a local shopping centre and bus routes. There is wheelchair access to the practice.

The premises consist of a waiting room, a reception area, an office, kitchen, staff room, a storage room, a decontamination room and two treatment rooms on the ground floor. The first floor comprises of another decontamination room, two treatment rooms, an office and a second waiting room. There are toilet facilities on the ground floor for staff and for patients and these are wheelchair-accessible. Two of the treatment rooms were not in use at the time of our visit. The practice opened between 8am and 5pm on Monday to Friday.

The provider is registered with the Care Quality Commission (CQC) as an individual. 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.

Eight patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with patients. The information from patients was entirely positive. Patients were highly satisfied with their experience and they commented that staff were friendly, informative and pleasant. Patients confirmed that their dentist provided clear explanations about their treatment and kept them informed. Those that commented on cleanliness told us that the practice was always clean and tidy.

Our key findings were:

• The practice was organised and appeared clean and tidy on the day of our visit. Several patients also commented that this was their experience.
• Patients were able to make routine and emergency appointments when needed and gave us positive feedback about the service they received.
• An infection prevention and control policy was in place. We saw the decontamination procedures followed recommended guidance. We identified some necessary improvements and these were promptly resolved.
• The practice had systems to assess and manage risks to patients, including health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. We identified some necessary improvements and these were promptly resolved.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Staff received training appropriate to their roles.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• Practice meetings were used for shared learning.
• The practice demonstrated that they undertook audits in infection control, radiography and dental care record keeping.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review availability of 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 current Legionella risk assessment and implement the required actions.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.

We told the provider (who is also the dentist) forty-eight hours before our visit that we were coming. During our visit, we spoke with the dentist, four dental nurses and five people using the service.

All of the five people we spoke with very complimentary about the service they had received. One person told us “I have been to many dentists before, and I speak as I find, I could not wish for better treatment than what I have had here ’’. Another person told us “Staff are very supportive and the dentist is lovely, they have always explained every thing to me’’.

Treatment options were explained to people and they had time to consider their options. This meant a full discussion took place and people were given the information they needed to be able to make an informed decision about their treatment.

The provider had effective infection control procedures. This meant the risk of infection for people using the service was minimised.

Staff received a range of training so that they had up to date knowledge and skills in order to treat people safely when they attended the practice.

There were systems in place to monitor how the practice was run to ensure people received a quality service. This meant people using the service were asked their views about the service so the provider could use the information to improve.