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Inspection carried out on 6 June 2019

During a routine inspection

We carried out this announced inspection on 6 June 2019 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a second CQC inspector and a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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 in Rushden, a town located in the county of Northamptonshire. It provides NHS and mostly private treatment to adults and children. Services provided include general dentistry, orthodontics and implants. At the time of our inspection, the practice were not accepting new NHS patients.

There is level access for people who use wheelchairs and those with pushchairs with the use of a portable ramp. The practice does not have car parking facilities; parking is available on street and in local car parks within a short distance. Blue badge holders can park on the driveway in front of the premises.

The dental team includes three dentists, five dental nurses, one dental hygienist, one dental hygiene therapist, one receptionist and a practice manager. The practice has three treatment rooms, all on ground floor level.

The practice is owned by an individual who is the principal dentist there. They 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 collected 63 CQC comment cards filled in by patients. We also received some patient feedback through our website.

During the inspection we spoke with three dentists, three dental nurses and the practice manager. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday to Friday from 9am to 5.30pm.

Our key findings were:

  • The practice appeared clean and well maintained.
  • The provider had infection control procedures which reflected published guidance.
  • Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available; two sizes of oropharyngeal airways were missing from the kit however. We were informed after our inspection that they had been ordered.
  • The practice had most systems to help them manage risk to patients and staff. We noted an exception in relation to the non-use of rubber dam, by one member of the team.
  • The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
  • The provider had thorough staff recruitment procedures.
  • The clinical staff provided patients’ care and treatment in line with current guidelines.
  • Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
  • Staff were providing preventive care and supporting patients to ensure better oral health.
  • The appointment system took account of patients’ needs.
  • The practice was supported by a dedicated practice manager who split her duties across two sites owned by the provider. The provider had effective leadership and culture of continuous improvement.
  • Staff felt involved and supported and worked well as a team.
  • The provider asked staff and patients for feedback about the services they provided.
  • The provider dealt with complaints positively and efficiently.
  • The provider had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

  • Review the practice’s system for recording, investigating and reviewing less serious untoward incidents and accidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
  • Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
  • Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.