We carried out an announced comprehensive inspection on 17 December 2015 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

CQC inspected the practice on 3 October 2014 and asked the registered provider to make improvements regarding requirements relating to workers, supporting workers and assessing and monitoring the quality of service provision. We checked these areas as part of this comprehensive inspection and found this had been resolved.

The Corner Dental Practice is situated in Immingham, North East Lincolnshire. It offers mainly NHS treatment to patients of all ages but also offers private dental treatments. The services include preventative advice, treatment and routine restorative dental care.

The practice has two surgeries, a decontamination room, a waiting area and a reception area. Treatment rooms, waiting rooms and an accessible toilet are on the ground and there is step free access to the premises.

There is currently one dentist, a dental hygienist, a qualified dental nurse, four trainee dental nurses and a receptionist.

The opening hours are Monday to Friday 9-00am to 5-30pm.

On the day of inspection 16 patients provided feedback. The patients were positive about the care and treatment they received at the practice. They told us they were treated with dignity and respect in a clean and hygienic environment, informed of treatment options, were able to make appointments in a timely manner and that the staff were helpful and polite.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, fire and health and safety.
• Dental care records were detailed and showed that 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.
• Staff received training appropriate to their roles.
• Patients were treated with care, respect and dignity.
• Patients were able to make appointments in a timely manner at a time which suited them.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

• Aim to implement a system for the analysis of accidents.
• Aim to obtain child and adult self-inflating bags for the emergency resuscitation kit.

We looked at a sample of treatment records for patients treated on the morning of our visit. The records contained details of the condition of the teeth, gums and the soft tissues lining the mouth. These were carried out at each dental health assessment according to the records. This meant changes were identified and the patient was made aware of any changes.

It was clearly observed by us that clean and dirty instruments did not decontaminate each other. We asked the provider of dental services as well as a dental nurse if the dental hand pieces were sterilised between each patient and we were told that this was the case. This meant that patients can be assured that they were protected from the risk of infection.

There were ineffective recruitment and selection processes in place. Appropriate checks had not been undertaken before staff began work.

We found no evidence of a staff appraisal or supervision process. The provider told us, “We see each other on a regular basis so we don’t feel there was a need to have a formal review.” Formal supervisions and appraisals are a way of supporting staff to ensure they had the opportunity to express their views and discuss their professional development.

We found little evidence of a governance system to show that the organisation had implemented effective controls and monitor the quality of the service.

Patients we spoke with confirmed they were asked for their consent before any treatment and that their treatment options were discussed with them. Patients also confirmed they received information from the dentist about choices of treatment.

Patients spoke positively about their experience of treatment. One patient told us, “Today’s experience was outstanding; it is warm and welcoming; I asked for a running commentary and the dentist gave me this. When I had the tooth extracted, I was given advice on aftercare and I am in no pain whatsoever.”

We also reviewed responses to recent surveys and comments made by patients. Typical of the responses we saw was, “I am very satisfied with the overall service and very happy to be a patient at this practice.”

Patients' comments about cleanliness included, “It is clean; staff have clean uniforms on,” and “It is very clean; staff wore protective equipment and I was given safety glasses and a bib was tied.”

Patients spoke positively about staff. Typical of patient responses was, “The staff are all friendly and helpful.” A patient commented in a recent survey, “Reception particularly friendly and welcoming; an asset to the practice.” The patient also commented favourably on the dental practice team.

The provider told us that patient satisfaction questionnaires were undertaken quarterly and we saw the results of these. However, the surveys were undated, and not formally analysed to identify particular trends.