We carried out this announced inspection on 9 May 2017 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 specialist dental advisor.

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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Archway Dental Practice is located in the centre of the busy Cotswold town of Dursley offering both private and NHS treatment to patients of all ages.

The practice relocated to a former doctor’s surgery in 2000 and has nine surgeries. There is level access from the street for people who use wheelchairs and pushchairs and facilities are accessible on the ground floor. Car parking spaces are available near the practice. The practice is well located near a main bus route.

The dental team includes 12 dentists, a dental hygienist, 13 dental nurses, three trainee dental nurses and four receptionists. The team is supported by a practice manager. The practice has nine treatment rooms.

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 50 CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.

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

The practice is open Monday 9:00am - 5:30pm: Tuesday, Wednesday and Friday 8:00am - 5:00pm: Thursday 9:00am - 6:00pm. The practice is closed at weekends but the out of hours emergency arrangements are displayed on their website. Contact information is available from the practice telephone answering service.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• 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.
• The appointment system met patients’ needs and dedicated emergency appointments were available.
• The practice used digital radiographs via a patient screen to help explain necessary treatment to patients while in the chair.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice had recruitment procedures in place.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review staff training to ensure that all of the staff had undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.

We spoke with seven patients when we visited. All of the patients we spoke with had attended for routine dental check-ups. One patient told us they had previously attended for emergency treatment and had been able to get an appointment easily. They said that they were involved in making decisions about treatment plans, that all options were explained and the costs were explained.

There were eight emergency dental appointments available per day. This was done so that emergency appointments did not impact upon patients who had a planned visit to the practice.

Patients that we spoke with said that the surgery and waiting areas were always clean and tidy. Plans were already drawn up and work had started to convert the adjacent building into two dedicated decontamination rooms and one new surgery. We have asked the practice to make some immediate improvements with the current procedures they follow to decontaminate used dental instruments.