We carried out an announced comprehensive inspection on 22 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

The Osborne Street Dental Practice is situated in Grimsby town centre. It offers mainly NHS treatment to patients of all ages but also offers private dental treatments. The services include preventative advice and treatments and routine restorative dental care and dental implants. It also runs the out of hours emergency dental service for the local area. The appointments for the out of hours service are booked through an external call centre.

The practice has four surgeries, a decontamination room, two waiting areas and a reception area. There are three surgeries, the reception area and a waiting area on the ground floor and one surgery and another waiting area on the first floor.

There are five dentists, 11 dental nurses, two receptionists, a practice manager and an assistant manager. For the emergency out of hours service there are an additional five dentists, three dental nurses and a receptionist. The dentists and dental nurses work on a rota basis for the emergency out of hours service.

The opening hours are Monday to Friday 9-00am to 5-00pm. The opening hours for the out of hours emergency service are Monday and Wednesday 5-00pm to 9-00pm, Tuesday, Thursday and Friday 6-00pm to 9-00pm and Saturday and Sunday 1-00pm to 5-00pm.

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.

On the day of inspection eight 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 tidy environment, informed of treatment options, were able to make appointments in a timely manner and were made to feel comfortable and relaxed.

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.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Patients told us they 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. Patients commented they felt involved in their treatment and that it was fully explained to them.
• Patients were able to make routine and emergency appointments when needed.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• 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. Staff received training appropriate to their roles.

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

• Document action plans for the clinical record audits.

A dentist we spoke with said, “I gain patient’s consent by giving them choices, I explain their options, show them a smile simulation or use photos, they make the decision then we both sign the treatment plan to confirm their agreement.”

Patients we spoke with told us, “I’ve got no worries at all, it’s a good dentist”, “Everyone is always polite and courteous”, “It’s good compared to my last dentist everything is explained to you here” and “I’m very happy here.”

Patient’s opinions were captured from a recent survey. Comments included, “The nurses and dentists here have helped me overcome my fear of dentists” and “My dentist and nurse are excellent with me and take into account I am a very nervy patient.”

We saw that waste was separated into three types of bins, soft and hard clinical waste and non clinical waste. We saw evidence that all clinical waste was collected by an organisation that was certified to dispose of it safely on a weekly basis.

A dentist we spoke with said, “It’s a good place to work, we look after each other.” A dental nurse told us, “It’s a great place to work, I really like it here” and “It’s a supportive environment, we all get on like a house on fire.”

An audit plan was in place to ensure risks to the business were managed and monitored effectively. The practice’s general manager described a range of audits that were completed on a yearly basis.

As part of our inspection we spoke with a number of people who use the service. They spoke positively and negatively about the treatment and support they received. They told us they liked all the staff and confirmed they felt supported to make choices and decisions about the care they received.

Positive comments included "Staff are wonderful", "Give explanations for every treatment." "Staff are friendly and helpful" and "See the same dentist."

Negative comments included "Don't always get into appointment on time and have to sit and wait", "Don't know who I am speaking to when I ring up" and "Treat you differently when you are old."