We carried out an announced comprehensive inspection on 17 October 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

The practice is located on two floors of premises in the Hyson Green area of Nottingham. The practice provides mostly NHS dental treatments (95%). There are a number of free car parks in the area including the park and ride at the nearby tram stop. There are 17 treatment rooms 14 of which are located on the ground floor.

The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are – Monday to Saturday: 9 am to 6 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message or by telephoning the 111 NHS service.

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.

The practice has 15 dentists; eight qualified dental nurses; ten trainee nurses; and one practice manager. Dental nurses also worked on the reception desk when required. In addition two oral surgeons visited the practice on a sessional basis several times a month.

We received positive feedback from 32 patients about the services provided. This was by speaking with patients and through comment cards left at the practice prior to the inspection.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients. A large pool of staff identified that staff shortages were easily covered.
• Patients commented they had no problem getting an appointment that suited their needs.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect; and the dentist involved them in discussions about treatment options and answered questions.
• Patients’ confidentiality was protected.
• There were systems to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.

Our observations and discussions with people who used the practice confirmed to us that people provided their consent. If a patient changed their mind about treatment, this was respected. People were provided with choices and information to support any decisions that had to be made about their treatment.

We found that treatment plans were developed with the patient and people we spoke with told us that they received a copy of their treatment plan. People using the practice also told us that they were provided with information about treatment options as well as the risks and benefits of each option.

Everyone we spoke with who used the practice told us they had a positive experience with their treatments and that they were happy with the service they received.

At this inspection all areas of the service were visibly clean, tidy and well maintained. We found that the cleaning routines and systems in place supported the wellbeing and health of people. Documentation also evidenced that regular checks were completed to ensure all cleaning and decontamination processes were undertaken when needed.

Quality audits were regularly carried out to ensure that the views of people were gathered on the quality of the service provided and the results of these showed that people were satisfied with their treatment.