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Inspection carried out on 15 September 2016

During a routine inspection

We carried out an announced comprehensive inspection on 15 September 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

Dental Practice 2 is situated in the Gosforth area of Newcastle, Tyne and Wear. It offers mainly NHS dental treatments to patients of all ages but also offers private options. The services include preventative advice and treatment, routine restorative dental care, orthodontics and dental implants.

The practice has three surgeries, a decontamination room, a waiting area, a reception area, a seminar room and an X-ray room. The reception area, waiting area, X-ray room and two of the surgeries are on the ground floor of the premises. The other surgery is on the first floor.

There is step free access to the premises and a ground floor accessible toilet. The practice is a training practice for newly qualified dentists or dentists from overseas (foundation dentist). Training practices have been approved by the regional postgraduate deanery to provide education supervision to foundation dentists.

There are six dentists (including a foundation dentist), one dental hygiene therapist, four dental nurses (including two trainee dental nurses) and a practice manager. The dental nurses also cover reception duties on a rota basis.

The opening hours are Monday to Wednesday from 9-00am to 5-30pm, Thursday from 8-30am to 5-00pm and Friday from 8-30am to 4-30pm.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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.

During the inspection we received feedback from 18 patients. The patients were positive about the care and treatment they received at the practice. Comments included that staff were friendly, helpful and charming. They also commented that the premises were always clean and hygienic and they felt safe and comfortable.

Our key findings were:

  • The practice was visibly clean and uncluttered.
  • The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
  • Staff were qualified and had received training appropriate to their roles.
  • Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
  • Dental care records showed that treatment was planned in line with current best practice guidelines.
  • Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
  • We observed that patients 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.
  • The practice had an effective complaints system in place.
  • Patients were able to make routine and emergency appointments when needed.
  • The governance systems were effective.
  • 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.
  • There were some gaps in the servicing history of the Orthopantomogram (OPG) machine.
  • There was an accessible toilet but this was partially obstructed by an X-ray machine.

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

  • Review the process for checking medical emergency equipment and medicines.
  • Review the availability of a plinth under the handwashing sink in the decontamination room.
  • Review the protocols and procedures for use of X-ray equipment giving due regard to guidance notes on the safe use of X-ray Equipment.
  • Establish whether the practice is in compliant with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
  • Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010.

Inspection carried out on 14 January 2013

During a routine inspection

Patients were given a full assessment of their oral health and were asked to provide a medical history, to make sure that all their needs were taken into consideration. Following assessment, treatment options were discussed and agreed with the patient, and a treatment plan was drawn up.

Patients always gave their written consent before any treatment was started, and they were asked to confirm their consent at each stage of their treatment. One patient told us, �I was given my treatment plan in writing, and I had to sign my consent�.

Patients spoke very highly of their care and treatment at the practice. Comments included, �The staff are all excellent�; �First class service�; and, �I cannot fault them, over a long number of years. I have absolute trust in them all�.

Staff had been trained to recognise the signs of abuse of children and vulnerable adults, and knew how to report any safeguarding issues.

The practice had effective systems in place for ensuring cleanliness and infection control, and had the appropriate equipment to clean and sterilise dental instruments after use.

Staff took responsibility for their continuous professional development, and had regular appraisals of their work by the provider.

The practice took seriously any feedback, including comments and complaints, and used feedback to improve its service. Complaints were responded to professionally and appropriately.