We carried out a focussed follow-up inspection on 2 August 2016 to check the practice had achieved compliance following our inspection of 30 July 2015. We concentrated on the following key question: Are services well-led?

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Our key findings were:

• 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.
• There were systems in place to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.

We carried out an announced comprehensive inspection on 30 July 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 not providing well-led care in accordance with the relevant regulations.

Background

We carried out an announced comprehensive inspection on 30 July 2015 at Smallthorne Family Dental Practice.

The practice provides dental care and treatment to registered patients from Monday to Friday 8:30am to 5:30pm. At the time of the inspection the practice had around 15,000 registered patients the majority of whom are NHS funded. The practice has seven dentists working a variety of clinical sessions over a week. The practice manager is one of two qualified dental nurses, there are also three trainee dental nurses employed, all undergoing recognised training leading to professional registration. A receptionist and business manager assist in the day to day running of the practice.

The principal dentist is the registered provider. A registered provider is registered with the Care Quality Commission to manage the service. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Sixteen patients provided feedback about the practice. They were all positive about access to appointments, their care and treatment and made complimentary remarks about their overall experience of the practice.

Our key findings were:

• Patients told us that their care and treatment was explained and they felt involved in decisions about their treatment.
• The appointments system met the needs of patients.
• The practice had effective infection control procedures.
• Although the practice managed most risks robustly. We saw the way the practice investigated and recorded incidents or near misses was not comprehensive.
• Patients received clear explanations and written information about their proposed treatment, costs, benefits and risks and were involved in making decisions about them.
• The practice sought feedback from staff and patients about the services they provided.

We identified regulations that were not being met and the provider must:

• Ensure that incidents that may affect the health and safety of people using the service are thoroughly recorded and investigated. Action should be taken to monitor and minimise further occurrences.

You can see full details of the regulations not being met at the end of this report.

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

• Review the decision not to provide staff with recognised training in safeguarding children to the level suggested in the intercollegiate guidance by the Royal College of Paediatrics and Child Health on safeguarding children and young people (March 2014).
• Provide practice staff with immediate access to an Automated External Defibrillator (AED) as recommended in The Resuscitation Council (UK) Quality standards for cardiopulmonary resuscitation practice and training.