We carried out an announced comprehensive inspection on 30 March 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 Bridge Dental Practice is situated in the basement of a large property on the main street in the centre of Marple Bridge. The practice is accessed via a small flight of stairs. Due to the age and design of the building there is no disabled access. People who require disabled access would be signposted to accessible dental practices in the local area. Parking is available in one of the municipal car parks. The practice offers predominantly (90%) NHS primary care dentistry to adults and children and a small amount (10%) of private treatments.

The staff group consists of the principal dentist, four associate dentists, a dental hygienist, a dental therapist and an orthodontist. They are supported by three registered dental nurses a registered orthodontic nurse and two apprentice nurses. There is a practice manager and a deputy manager who are also dental nurses. Reception duties are covered by the dental nurses on a rota basis. The practice is a member of the British Dental Association (BDA) Good Practice Scheme. There were three treatment rooms, a dedicated decontamination room, reception/waiting area, toilet and a staff kitchen.

The practice opening hours are Monday to Thursday 8.45am to 5pm and Friday 8.45am to 4.30pm. Appointments are available on Saturday by appointment only.

The principal dentist (the owner) is the registered provider. Registered providers 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 received feedback from 34 patients via CQC comment cards and speaking to patients on the day of the inspection.

Our key findings were:

• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had an automated external defibrillator and medical oxygen was available on the premises.
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.

• Governance arrangements were in place for the smooth running of the practice that included a system of audits to monitor the quality of the service.

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, fire safety and health and safety.
• Patients were able to access both routine and emergency appointments and there were clear instructions on how to access out of hours emergency dental treatment.
• The practice had procedures in place to take into account any comments, concerns or complaints that were made to improve the practice.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit’ (DBOH).

During our inspection in February 2012 we found that support provided to staff through regular supervision sessions needed improvement. We did not see evidence of formal staff appraisals and further development was needed in their staff induction program. Following the inspection the provider wrote to us to explain how they proposed to address the matters we had brought to their attention. We carried out this inspection to check action had been taken.

During the inspection 14 August 2014 we saw that significant improvements had been made.

Staff received an appraisal twice a year, usually attended meetings training sessions on a monthly basis and a staff training schedule was in place.

An induction training program was in place for new dental trainee nurses and this induction could be moderated for any newly recruited qualified dental nurses.

The staff we spoke with said they enjoyed their work and felt well supported in their role.

After our visit to the surgery we spoke with patients on the telephone. Comments included: “I signed a consent form and have a copy of it”, “they are very obliging we are very happy with them”, “they are very good”, “always gives an estimate of how much treatment will cost”, “he does an examination and writes down what he finds”, “I have completed quite a few health questionnaires”, “I was advised of the costs and told how much my treatment would be” and “they usually give me information and there are leaflets in the surgery.”