We carried out an unannounced comprehensive inspection on 13 July 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 practice is located in premises close to Grantham town centre. The practice provides a mixture of private and NHS dental treatments. Approximately 70% of the treatment is provided to NHS patients. There is a small car park to the front of the practice and disabled parking on the roadside outside for blue badge holders. There are twelve treatment rooms all of which are located on the ground floor.

The practice was first registered with the Care Quality Commission (CQC) in July 2011. The practice provides regulated dental services to both adults and children. Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are - Monday: 8:45 am to 7 pm; Tuesday 8:45 am to 6:30 pm; Wednesday: 8:45 am to 5 pm; Thursday: 8:45 am to 5 pm; Friday: 8:45 am to 4 pm and alternate Saturdays from 9 am to 1 pm.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients could telephone the NHS 111 telephone number.

One of the partners 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.

The practice has ten dentists; three oral surgeons; one orthodontist; and one practitioner with a special interest in orthodontics. four dental hygienists; twelve qualified dental nurses; two trainee dental nurses; six receptionists and a practice manager.

We received positive feedback from three patients about the services provided. This was by speaking with patients in the practice.

Our key findings were:

• There were systems in place to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
• The practice provided a sedation service for nervous patients or those requiring oral surgery. The guidance relating to sedation was being followed.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment. This included an automated external defibrillator, oxygen and emergency medicines.
• The practice was visibly clean and tidy.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control with regard to cleaning and sterilizing dental instruments.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Dentists identified the different treatment options, and discussed these with patients.
• Patients’ confidentiality was maintained.
• Patients said they had no difficulty getting an appointment that suited their needs.
• Patients we spoke with at the practice provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect.
• The practice was well equipped and provided a relaxed atmosphere for patients.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• Patients were able to express their views and comments, and the practice listened to those views and acted upon them.

We used a number of different methods to help us reach a judgement on this service. These including talking with patients using the service, members of the staff team, observation and looking at records.

We spoke with three patients, two dentists, three members of staff and the practice manager. We also looked at records. These included care plans, records of meetings and information about how the service operated. We looked at information from surveys undertaken by the provider to assess the quality of service.

Patients we spoke with said they were fully involved in their care and treatment options, felt it was delivered in a safe way and that the practice was clean and hygienic.

One patient told us, “I have been coming here for a long time and the service I have received is first class.”

Another said, “It’s very good. I’m a private patient and could go elsewhere but this is the best.”

We observed members of staff interacting with patients in courteous, polite and efficient manner.

We saw that the practice had implemented a clear infection control policy and that staff were encouraged to develop their skills and undertake appropriate training to help deliver safe and effective care to patients.

You can see our judgements on the front page of this report.