We carried out an announced comprehensive inspection on 25 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 Station Dental Practice has three dentists who work full time, three qualified dental nurses who are registered with the General Dental Council (GDC), two trainee dental nurses, a practice manager and a receptionist. The practice’s opening hours are 9am to 5.30pm on Monday to Friday.

The Station Dental Practice provides NHS and private dental treatment for adults and children. The practice has three dental treatment rooms on the ground floor. There is a separate decontamination room for cleaning, sterilising and packing dental instruments. There is also a reception and waiting area.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

Before the inspection we sent Care Quality Commission comments cards to the practice for patients to complete to tell us about their experience of the practice and during the inspection we spoke with patients. We received feedback from 10 patients who provided a positive view of the services the practice provides. All of the patients commented that the quality of care was good.

Our key findings were

• Systems in place for the recording and learning from significant events and accidents were not robust.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect.
• Rubber dam kits had recently been made available and although these had not been previously used by the dentist we were told that these would be used in the future.
• The practice was visibly clean and well maintained.
• The practice was not completing all pre-employment checks such as pre-employment medical questionnaires.
• Infection prevention and control audits had not been undertaken on a six monthly basis, the date of the last audit was February 2016. Following this inspection we were forwarded a copy of an audit completed on 26 October 2016.
• Not all issues identified in the practice’s fire risk assessment had been addressed.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.
• Staff had been trained to deal with medical emergencies.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• Patient care records did not all record information regarding discussions held about treatment options and any risks of treatment. There were no leaflets available to provide information to patients about dental treatments or oral health.
• The practice did not have robust systems in place to monitor quality, at the time of inspection there had been no X-ray audit or record card audit within the last 18 months. The practice was not completing patient satisfaction surveys apart from the NHS Friends and Family Test. The practice manager forwarded a copy of an X-ray audit following this inspection.

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

• Review the practice’s safety systems to include the implementation of a robust system for the recording and reviewing of accidents or significant events and provide evidence of action taken to prevent further occurrences or ensure that improvements are made as a result.
• Review systems and processes in place at the practice to protect patients undergoing root canal treatment.
• Review the security of prescription pads in the practice.
• Review the recruitment procedures and protocols to ensure that all pre-employment information is obtained in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

• Review the practice’s fire safety procedures and ensure that issues identified in the practice’s fire risk assessment have been addressed.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s protocols for completion of clinical audit to include a review of the frequency of audits such as radiography, record card and infection prevention and control audits.

Our visit was discussed and arranged with the practice a few days in advance. This was to ensure that we had time to see and speak with staff working at the practice, as well as people registered with the practice. We asked the staff at the practice to issue a questionnaire to some of the people who received a service.

As part of our visit, we spoke with nine people who were registered with the practice. We also spoke with the two dentists and their staff about working at the practice.

People that used the practice told us that they were happy with the quality of treatment received. They felt they were given enough information about their treatment options and the relevant fees, and were able to ask all the questions they wanted to.

Comments that we received in the thirteen questionnaires that we received included:-

‘This is a well run practice.

Good quality dental care.

Good service, friendly staff.

Never have to wait long, staff are friendly, treatment is good.

Listen to you and make you feel at ease.

They are marvellous and so their best to make me feel comfortable.’

People told us that the practice was clean and tidy and had no concerns about hygiene standards.