We carried out an announced comprehensive inspection on 6 December 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

Established in 2010, Snaith dental care is located in a purpose-built premise and provides NHS and private treatment. There are two treatment rooms, a decontamination rooms for sterilising dental instruments and an instrument storage area, a staff room/kitchen and a general office.

Access for wheelchair users or pushchairs is possible and a permanent ramp with hand rails lead to a ground floor entrance, straight into the spacious reception and waiting area. Ample car parking spaces are available near the practice.

The dental team is comprised of one dentist and four dental nurse’s one of which works as the practice manager.

The practice is open:

Monday 09:00 - 19:00

Tuesday 08:30 - 19:10

Wednesday 09:00 - 17:00

Thursday 08:30 - 19:10

Friday 08:30 - 17:30

Saturday 08:30 - 11:30.

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 15 CQC comment cards providing feedback. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were treated with dignity and respect, staff listened and responded to their needs and concerns and they were always friendly and professional. 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.
• We found the practice did not have an automated external defibrillator on site and no risk assessment was in place to mitigate its absence.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
• The practice 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 guidance published by the Department of Health. Daily and weekly testing of equipment required improvement.
• 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 governance systems were not 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 infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum

01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Review the practice’s system for the recording, investigating and reviewing significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result.
• Review availability and accessibility of an AED 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 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 the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance
• Review the arrangements for staff immunisation to reflect guidance issued by PHE.
• Consider the need to risk assess lone workers and the need for a policy.
• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development.
• Review the practice audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.

Snaith Dental Care was a small practice with two dentists and four dental nurses. We were able to speak with one dentist and two dental nurses during our visit. We also spoke with three patients who attended appointments.

Patients who received treatment at Snaith Dental Care practice told us that they were very happy with the care and treatment they received and they had confidence in the staff.

Patients who spoke with us said the staff were polite and approachable and the dentist took time to listen to and answer any questions they might have. Patients told us that they were impressed with the efficient and friendly service and they felt the hygiene and cleanliness of the practice was "Excellent".