We carried out an announced comprehensive inspection on 22 February 2017 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

Soar Valley Dental Practice is a dental practice providing primarily private with some NHS care for adults and children. Where private treatment is provided some is under a fee per item basis and some under a dental insurance plan. The practice is situated in a converted property and has three dental treatment rooms; one on the ground floor and two on the first floor. There is also a reception and waiting area on the ground floor and a waiting room and a care suite on the first floor. The care suite was used for private discussions regarding treatments with patients. There were also other rooms used by the practice for office facilities and storage. The practice is open from 9.00am to 6.00pm Monday to Thursday and from 9.00am to 2.00pm on Fridays. The practice closes for lunch from 1.00pm to 2.00pm.

The practice has two full time dentists, one of them being the principal dentist and the other a foundation dentist (a foundation dentist is a dentist undertaking a post-qualification training period, in general dental practice. UK graduates need to undertake this in order to work in NHS practice). There are also two part time associate dentists. They are supported by three dental nurses, a trainee dental nurse, three part time dental hygienists, a practice manager, a care coordinator and two receptionists.

The practice is able to provide general dental services including endodontic (root canal) treatment, orthodontic treatment and some cosmetic dentistry.

The principal dentist is registered with the Care Quality Commission as an individual and also as the registered manager. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We also spoke with patients on the day of our inspection. We received feedback from a total of eleven patients. All feedback was positive with patients commenting favourably on the quality of care and service they received, the professional and helpful nature of staff and the cleanliness of the practice.

Our key findings were:

• Staff reported incidents which were investigated, discussed and learning implemented to improve safety.
• The practice was visibly clean and well maintained and Iinfection control procedures were in line with the requirements of the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices’ published by the Department of Health, with the exception of incomplete records of water temperature monitoring in relation to the risks associated with legionella.
• The practice had medicines and equipment for use in a medical emergency which were in accordance with national guidelines with the exception that there were no paediatric masks and the tubing on the portable suction was too short. We were informed following our inspection that these items had been purchased.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

• Staff demonstrated a strong commitment to oral health promotion and the foundation dentist and oral health educator carried out visits to local schools and playgroups to give talks to children to promote oral health.

• Patients commented that they were pleased with the care they received and that staff were helpful, kind and courteous.

• The practice had suitable facilities and was equipped to treat patients and meet their needs. However we found that there were gaps in the recording of testing of equipment used in the decontamination process. We were told following our inspection that the process had been changed to ensure this would not happen again.

• Translation services were available. There was no hearing loop to assist patients with a hearing impairment but the practice told us they had purchased one following our inspection.

• The practice had a process in place to make referrals to other dental professionals when appropriate to do so but there was no system to track referrals.

• Governance arrangements were in place for the smooth running of the service.

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

• Review the practice’s referral processes to allow referrals to be monitored.
• Review the current arrangements for recording of water temperatures in respect of mitigating the risks associated with legionella, giving 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 systems in place to ensure that the equipment used in the decontamination process is working effectively.

We spoke with three people who used the service and they all said they were satisfied with the level of service received. They were complimentary about the staff and said “He’s very caring, makes you feel comfortable and listens to you”, “I now do look after my teeth and gums much better” and “they always ask if I’m happy with the treatment.”

People told us the treatment options were explained to them and they made the decision about the treatment that best suited them. They said “They examine you, explain the problem and the treatment needed” and “they tell you what it will cost and how long the treatment will take”.

People told us the practice was always clean and the staff always wore glasses, face masks and gloves during treatment. They said “Cleanliness is very good” and “instruments are put out when you go in.”