We carried out an announced comprehensive inspection on 5 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 practice is located in premises close to the centre of Wellingborough in Northamptonshire. There is road side parking close to the dental practice. There are four treatment rooms. Any patients with restricted mobility would be seen and treated at the provider’s other practice on the opposite side of the road as this practice had level access and facilities to meet the needs of patients with restricted mobility

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 provided mostly NHS dental treatment.

The practice’s opening hours are – Monday to Thursday: 8am to 6:30 pm, Friday: 8 am to 5:30 pm. The practice is closed at weekends.

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.

The practice had a number of registered managers: the practice manager and four dentists. 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 is registered with the Care Quality Commission (CQC) as an organisation.

The practice has five dentists; two therapists; ten qualified dental nurses; one trainee dental nurse and two receptionists.

We received feedback from 147 patients about the services provided. This was by speaking with patients, through comment cards left at the practice prior to the inspection and through patients who contacted CQC directly. The majority of feedback was positive with most patients happy with the care and treatment they received at the practice.

Our key findings were:

• The premises were visibly clean and there were systems and processes in place to maintain the cleanliness.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients said they had no problem getting an appointment that suited their needs.
• Patients were able to access emergency treatment when they were in pain.
• Patients provided positive feedback about their experiences at the practice. Patients said they were treated with dignity and respect; and the dentist involved them in discussions about treatment options and answered questions.
• Patients’ confidentiality was protected.
• There were systems to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• 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.
• There were arrangements for patients with restricted mobility to be seen quickly and easily at a nearby practice (on the other side of the road) owned by the same provider.
• There was a whistleblowing policy accessible to all staff, who were aware of procedures to follow if they had any concerns.
• 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.

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

Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and consider installing a hearing induction loop at the premises. This would assist patients who use a hearing aid whilst in the practice. 

We spoke with patients who use the practice and with staff who worked at the practice. The people we spoke with said they were happy with the service they received.

We asked the people who used the service about the availability of appointments and if they had to wait over their appointment time to be seen. The people we spoke to told us; "I never have a problem with getting an appointment.” Another told us, “They explain the treatment and you can have instalments on treatment costs.”

We saw that the practice had one surgery on the ground floor with others accessible by stairs. Staff told us that if a patient had mobility problems they would be seen by their dentist in the ground floor surgery.

We spoke to staff who told us they were happy working at the practice and that they felt they received a good level of training and support.

We looked around the practice, reviewed systems in place about the cleanliness and hygiene practices. Staff showed us the decontamination facilities and said they felt confident with the procedures in place.

With the permission of patients we observed some treatments in the surgery. We saw that the dentists and nurses wore appropriate protective clothing, welcomed the patients and explained the treatment options to them fully.