We carried out an announced comprehensive inspection on 14 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

St Andrew's Dental Care is a dental practice providing NHS and private treatment for both adults and children. The practice is based in a converted mid-terraced property.

There are two treatment rooms located on the ground and first floor, two waiting areas and a staff kitchen. Parking is available on the side-streets near the practice. The practice is accessible to people with disabilities and impaired mobility.

There are two dentists, a part time dental therapist and three dental nurses, one of whom is a trainee. The clinical team is supported by a practice manager. The practice’s opening hours are 9am to 5.30pm Monday and Wednesday, 10am to 7.30pm Tuesday and Thursday and 9am to 1pm on Friday. The practice closes for an hour every day for lunch.

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

We reviewed 39 CQC comment cards on the day of our visit; patients were extremely positive about the staff and the standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• The premises had undergone refurbishment and was visibly clean and tidy.
• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

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

• Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.

• Review the practice’s process to ensure equipment is serviced and maintained in line with manufacturers guidance.

• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

As part of this inspection we obtained the views of seven patients. They all gave us positive feedback about the service they received. Their comments included "Excellent service and patient care", "Service is excellent, wouldn't change them for the world" and "[The staff are] helpful and considerate, always willing to give advice". Patients told us they were asked to give consent, either verbally or in writing, prior to treatment commencing.

We saw that various assessments were carried out by the dentist at each routine appointment. Where more complicated treatment was required patients were given further information and were given time to consider their options.

The practice was clean and regular checks were carried out to make sure the risk of infection was minimised. Protective clothing was available for patients and staff.

There was a complaints procedure in place and this was displayed in the waiting area.