We carried out an announced comprehensive inspection on 28 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

The Carnegie Clinic is situated in Shipley, West Yorkshire. The practice provides dental treatment to adults and children on an NHS or privately funded basis. The services include preventative advice and treatment and routine restorative dental care.

The practice has four surgeries, a decontamination room, two waiting areas and a reception area. There are two surgeries, a waiting area, the reception area and accessible toilet facilities on the ground floor. The other two surgeries and the second waiting area are on the second floor.

There are three dentists, three dental hygiene therapists, one dental hygienist, six dental nurses (two of whom are trainees), one receptionist and a practice manager.

The opening hours are Monday from 9:00am to 7:00pm, Tuesday and Friday from 8:00am to 4:00pm and Wednesday and Thursday from 10:00am to 7:00pm.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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.

During the inspection we received feedback from 33 patients. The patients were positive about the care and treatment they received at the practice. Comments included staff were polite, considerate and helpful. They also commented that it was easy to book an appointment and they were made to feel at ease and the practice is clean and hygienic.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed patients were treated with kindness and respect by staff.
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• Patients were able to make routine and emergency appointments when needed.
• The governance systems were effective.
• There were clearly defined leadership roles within the practice and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

• 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 staff awareness of the practice’s safeguarding policy and procedures and ensure all staff are aware of their responsibilities.
• Review the practice’s process for risk assessing new members of staff who have not yet completed a full course of Hepatitis B vaccinations.
• Review the practice’s process for monitoring referrals.

During the inspection we had the opportunity to speak with two people who used the service. They told us they were very satisfied with the care and treatment provided and said they thought the surgery was clean and hygienic. However, both people said if they did have a concern they would raise it with practice manager or dentist and were confident it would be dealt with appropriately.

We found the provider had appropriate systems in place to ensure consent was gained before they proceeded with an examination or treatment.

We found the provider had taken steps to ensure the care and welfare of people who used the service and there were arrangements in place to deal with medical emergencies.

We found the provider operated in clean and tidy facilities and had suitable infection prevention and control protocols in place.

We found the provider had appropriate arrangements in place to ensure staff were receiving suitable training and opportunities for personal development.