We carried out an announced comprehensive inspection on 10 October 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

St James Dental Centre has one dentist who works part time, a part time dental hygienist, three qualified dental nurses who are registered with the General Dental Council (GDC), a practice manager and a receptionist. The practice’s opening hours are 8.30am to 6pm on Monday 8.30am to 1pm on Wednesday and 8.30am to 5.30pm on Friday.

St James Dental Centre provides private dental treatment for adults and children. The practice has two dental treatment rooms on the ground floor. Sterilisation and packing of dental instruments takes place in the treatment room. There is a reception with separate waiting area.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice. During the inspection we spoke with three patients. Overall we received feedback from 35 patients who provided an overwhelmingly positive view of the services the practice provides. All of the patients commented that the quality of care was very good and staff were friendly and caring.

Our key findings were

• Systems were in place for the recording and learning from significant events and accidents.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect.
• The practice was visibly clean and well maintained.
• Infection control procedures were in place with infection prevention and control audits being undertaken on a six monthly basis. Staff had access to personal protective equipment such as gloves and aprons.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. Staff had been trained to deal with medical emergencies.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The governance systems were effective.
• The practice was well-led and there were clearly defined leadership roles within the practice. Staff told us they felt supported, involved and they all worked as a team.

There were areas where the provider could make improvements and should

• Review the practice’s RIDDOR policy to ensure correct information regarding reporting information under RIDDOR regulations is recorded.
• Review the practice’s procedures regarding medicines and equipment to be used in a medical emergency to ensure that the frequency of checks completed is in line with the Resuscitation Council (UK) guidance.
• Review the systems in place for managing first aid and provide evidence that those staff identified as the designated first aider has completed relevant training.
• Review the practice's protocols for completion of dental records and ensure that the dental hygienist gives due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the systems in place to ensure firefighting equipment at the practice is serviced, maintained and checked on a regular basis.

We conducted telephone interviews with four people who use the service and received one comment from the local intelligent network (LINKS). People told us that they were very happy with the care and treatment they received. They made some of the following comments:

“I am happy with the treatment given, if I wasn’t happy I would go somewhere else.”

“The surgery is clean and very nice, they wear gloves. I have never caught an infection after treatment.”

“She explains what needs to be done and how she is going to do it, she usually tells you what the alternative might be. On the odd occasion when I have lost a filling she will see me on the same day or the next. I have had excellent service. The staff are all very good and considerate.”

The facilities and resources offered at this practice include two surgery rooms, one part time dentist who is the registered provider, a part time dental hygienist, a full- time dental nurse, a trainee dental nurse and a receptionist.

The practice is located on the ground floor of the premises and has three steps leading up to it. A portable ramp is available to allow access for people with restricted mobility.

During the review we found that people are assessed to decide what dental and oral healthcare needs they may have. Treatments that people may need are discussed with them and are carried out in a way that reduces the risk of them being harmed.

We found that people receive treatment in an environment which was generally clean. However we have identified that improvements were needed to help to reduce the risks of cross infections.