We carried out an announced comprehensive inspection on 9 September 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 the first floor premises in the centre of the market town of Bakewell in north Derbyshire. The practice provides mostly NHS dental treatments. With approximately 85% of the treatment provided to NHS patients. There is pay and display car parking close to the dental practice. There are three treatment rooms all of which are located on the first floor. Access is either by stairs or a passenger lift for patients with restricted mobility or pushchairs.

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 Thursday: 9 am to 5 pm; Friday: 8:30 am to 2 pm. The practice is closed for lunch: 12:45 pm to 1:45 pm. The practice is closed at the weekends.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients could telephone the NHS 111 telephone number.

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

The practice has three dentists; one qualified dental nurse/ clinical manager; two recently qualified dental nurses who are awaiting their registration with the General Dental Council (GDC); and two administrative members of staff. Dental nurses also worked on the reception desk.

We received positive feedback from 45 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.
• Patients said 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.

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

• Review the protocols and procedures for use of X-ray equipment giving due regard to guidance notes on the Safe use of X-ray Equipment. Particularly in respect of replacing the X-ray sensors within the practice.
• Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and consider installing a hearing induction loop to assist patients and visitors who used a hearing aid.

We visited Smith Dental Practice and inspected the premises, spoke to staff and patients and reviewed documentation. The clinical manager responsible for the management of the practice was our main source of information. We found the Dental surgeries to be clean, and well equipped, and staff were both professional and knowledgeable.

Smith Dental Practice employed two dentists and one dental hygienist/ therapist. The dental surgery is located close to the centre of Bakewell. The dental surgery is located on the first floor of a building, with access by either stairs or a passenger lift. The lift made the surgery fully accessible for patients with restricted mobility.

We spoke with two National Health Service (NHS) patients at Smith Dental Practice. Both patients said that they were very happy with their dental treatment. One patient had been coming to the dental practice for ten years and the other for seven years.

We asked what was good about the dental practice and one patient told us: “It’s very calm, which helps me to be calm, they also keep me informed about what’s going on and they give you confidence.” In relation to the same question the second patient said: “they are very friendly, very accommodating, and it’s a very quick service.”