We carried out an announced comprehensive inspection on 14 October 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 Mapleleaf Practice is situated in the centre of Harrogate, North Yorkshire. The practice offers private dental treatments including preventative advice, general dentistry, dental implants and orthodontics.

The practice has three surgeries, one of which is on the lower ground level, a decontamination room, a waiting/reception area, an area for the Orthopantomogram (OPT) machine, and patient toilets. There are also staff facilities and offices.

There are three dentists, two dental hygienists, four dental nurses and a practice manager.

The practice is open:

Monday to Thursday 8:00am and 5:00pm

Friday 8:00am - 4:00pm.

One of the practice owners 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.

On the day of inspection we received 28 CQC comment cards providing feedback and we spoke with three patients. The patients who provided feedback were very positive about the care and attention to treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be very caring, they provide exceptional treatment, are very considerate and motivational; staff were friendly and communicated well. Patients commented they could access emergency care easily and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• The practice was visibly clean and uncluttered.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it. They had very good systems in place to work closely and share information with the local safeguarding team.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Infection control procedures were in accordance with the published guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Treatment was well planned and provided in line with current best practice guidelines.
• Patients received clear explanations about their proposed treatment, 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 patients’ needs.
• The practice was well-led and staff felt involved and supported and worked well as a team.
• The governance systems were effective and embedded.
• The practice sought feedback from staff and patients about the services they provided.
• There were clearly defined leadership roles within the practice and staff felt supported at all levels.

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 the requirement for an up to date legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the practice’s audit protocols of various aspects of the service, such as radiography at regular intervals to help improve the quality of service. Practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.

We spoke with three people who used the service. All of whom spoke positively about the practice. One person told us that: "I was very fearful of the dentist but they take their time and explain everything and are very reassuring.” And “The staff are excellent, it feels like you are the only patient because of the attention they give you.” Another patient told us

“Any treatment is fully explained with the options available; I am very happy and appreciative of the work they have done for me.”

People told us that they were always able to find an appointment time to suit them. People commented that they usually saw the dentist promptly within their appointment time. People said they were clear about the cost of their treatment. One person told us they were given choices in relation to their treatments and given the opportunity to ask questions.

We asked people about the cleanliness of the surgery and people said they found the surgery to be "spotless" and "always clean and tidy." The practice was clean and hygienic. We saw evidence that equipment was sterilised to the appropriate standards which reduced the risk of any cross infection to patients and staff.

The three people we spoke with knew to speak to a member of staff if they had a complaint and said that they would feel comfortable doing so.

We looked at three electronic patient records and saw they contained information about the person's oral health needs and the treatment provided.