We carried out an announced comprehensive inspection on 11 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

Shelswell Dental Practice Ltd is situated in Bessacarr, Doncaster. The practice offers mainly NHS treatment and occasional private dental treatments.

The practice has three surgeries, a decontamination room, a waiting and reception area and a patient toilet. There are also staff facilities and a store room.

There are two full time and two part time dentists, a part time dental hygienist, four dental nurses and two receptionists.

The practice is open between the hours of 9:00am and 5:30pm: Monday to Friday and by appointment only on Saturday 9:00am-13:00pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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.

On the day of inspection we received 32 CQC comment cards providing feedback. Patients who provided feedback were very positive about the care and attention to treatment they received at the practice. Comments included patients felt they were involved in all aspects of their care and found the staff to be very pleasant and helpful, the practice had a happy environment; staff were friendly and communicated well. Patients commented they could access emergency care easily and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• The practice was visibly clean and uncluttered.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in accordance with the published guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Treatment was well planned and provided in line with current best practice guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The governance systems were effective and embedded.
• The practice sought feedback from staff and patients about the services they provided.
• There were clearly defined leadership roles within the practice and staff felt supported at all levels.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and Gillick competence ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s waste handling policy and procedure to ensure waste is stored and disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• 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 paying particular attention to consent to treatment, tracking referrals and record card audits.
• Review the practice’s radiographic audit protocols and bring in line with National Radiographic Protection Board.

We spoke with three people who used the service. They spoke positively about the care and treatment they had received. They told us they were provided with sufficient information to make decisions about their treatment. One person told us: "Very good

service, I get good information. The dentist always discusses options and costs prior to my treatment." Another person said: "My family have come here for years. I am happy with the treatment. The staff always try and accomodate an appointment of my choice."

Evidence showed people were protected from the risk of infection because appropriate guidance had been followed. People we spoke with told us the surgery was very clean and staff always wore protective clothing when treating them.

Staff received appropriate professional development. A training programme was in place to provide staff with the training and support they needed to maintain their qualifications. People we spoke with told us staff were always polite and respectful and provided a good standard of care.

The dental practice had an effective system to regularly assess and monitor the quality of service that people received. There was evidence that learning from incidents and investigations took place and appropriate changes were implemented. The practice had a complaints policy and took account of complaints and comments to improve the service.