We carried out an announced comprehensive inspection on 22 August 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.

The Maltings Dental Practice is a mixed NHS and private practice in central St Albans, Hertfordshire. The practice offers a range of general dental treatment to adults and children. The premises are located in a shopping centre on the ground and first floor and consist of five dental treatment rooms, a large reception and waiting area and a designated decontamination room.

The staff at the practice consist of a six associate dentists (one of whom is the clinical director), a practice manager, two receptionists, two dental nurses and five trainee dental nurses. The practice also has a visiting specialist who provides orthodontic treatment on a private basis.

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.

Our key findings were:

• There was a comprehensive induction programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• The practice placed an emphasis on the promotion of oral and general health and the prevention of dental disease. Appropriate information and advice was available according to patients’ individual needs.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received comprehensive assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring, very welcoming and worked well as a team.

• There was an effective system in place to act on feedback received from patients and staff.
• We reviewed 15 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection. Common themes were patients felt they received a good service from staff who were kind, friendly, efficient and took time to answer their questions.

People told us that they were happy with the service provided and that their dignity was maintained and their privacy protected. They said that they were encouraged to ask questions and they felt that staff had the time to answer them. People reported that staff were good at discussing all their treatment options with them. One person told us, "It’s always clean and my dentist talks through the different options with me". We found that the practice listened to patients and care and treatment provided was

recorded.

Overall we found that the practice had good systems in place for ensuring cleanliness and hygiene was maintained although we found that some of the trays used to carry dental equipment were dirty and had limescale on them; we observed that most of these trays were disposed of during the inspection and we were assured that others would be cleaned.

Patient records contained appropriate information and medical histories were regularly checked; although records had not been subject to an audit by the practice. Staff files contained details of training courses attended, although they were not easy to follow and all staff were overdue for their training on basic life support.