We carried out an announced comprehensive inspection on 13 December 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

Bloxwich Dental Centre has four dentists; two who work full time and two who work part time (this includes the two owners of the practice), five 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 5pm on Monday to Thursday and 8.30am to 1pm on Friday. The practice closes for lunch each day between the hours of 1pm to 2pm.

Bloxwich Dental Centre provides mainly NHS dental treatments to patients of all ages but also offers private treatment options. The practice has one dental treatment room on the ground floor and two on the first floor. Cleaning, sterilisation and packing of dental instruments takes place in a separate decontamination room. There is a reception with adjoining waiting area and a separate waiting area on the first floor.

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. We received comments from 51 patients by way of these comment cards and during the inspection we spoke with one patient.

Our key findings were

• Systems were in place for the recording and learning from significant events and accidents.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect.
• The practice was visibly clean and well maintained.
• Infection control procedures were in place with infection prevention and control audits being undertaken recently. Staff had access to personal protective equipment such as gloves and aprons.
• There was appropriate equipment for staff to undertake their duties, however records were not available to demonstrate that all fire safety equipment was serviced or maintained. The practice manager notifified us the day following this inspection that an external professional has been booked to complete this on 22 December 2016.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Staff had been trained to deal with medical emergencies and the provider had emergency equipment in line with the Resuscitation Council (UK) guidelines. However not all medicines were available in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice. The practice manager confirmed that the missing medicine would be ordered as a matter of priority and confirmation was received that this had been ordered.
• There was no signage in place identifying that X-ray machinery was located in the room and critical examination packs for each of the X-ray sets were not available for review. X-ray signage was put in place the day following out inspection.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The governance systems were effective.
• The practice was well-led and there were clearly defined leadership roles within the practice. Staff told us they felt supported, involved and they all worked as a team.

There were areas where the provider could make improvements and should

• Review the practice’s systems to ensure that they are is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the practice’s consent policies and procedures giving due regard to the Mental Capacity Act 2005 (MCA) and ensure staff obtain a good understanding of processes involved in consent.

We arranged our visit over the telephone three working days before we arrived. This was done to ensure that relevant staff were available to talk with us.

We visited the service on 21 May 2012. We met with the practice manager and spoke with a dental nurse and the receptionist. We were introduced to two dentists and the other dental nurses on duty. There were three dentists and three dental nurses on duty at the time of our visit.

As part of the review process we spoke with five people over the telephone after our visit and one person who was at the dental centre on the day of our visit. We asked people about their experiences of using the dental service. Everyone spoken with was extremely happy with the service received. We also looked at the feedback recorded on the NHS Choices website. Feedback had been left by people who had used this dental surgery between November 2011 and March 2012. One person reported a negative experience regarding a mouth abscess which had caused them pain and comments made regarding their poor dental hygiene. We do not know whether this issue was reported to the dentist at the time. All others who left feedback on the NHS choices website were happy with the service provided by this dental practice. Some of the comments recorded on the website include " liked the service on offer here and the wide range of products that they were selling at affordable prices. The wait was not long and the staff were very friendly and the treatment finished well and within the given time." "Just a quick note to say how impressed I have been with the whole experience. The team do all appear to be very competent in their particular areas of expertise. I am very pleased and more than willing to be used as a reference if required."

People were asked if staff were friendly and welcoming, if they were given sufficient information about any treatment on offer and whether any treatment options and costs were explained.

People told us "They explain everything to you, including the costs. Dr XX is caring and explains everything, you get a choice." "I have never had any problems, I used to live in Bloxwich and have moved house a few times, I have moved out of the area but I still go to the same dentist because they meet all of my needs."

We were told that the surgery is always clean and that dental staff wear disposable gloves and aprons when providing treatment.

Everyone spoken with said that they could get an appointment when they needed one. One person spoken with on the day of our inspection was there for an emergency appointment and was grateful that they could be seen on the day that they had telephoned. We were told "I am going on holiday at the end of the week so they fitted me in straight away." People told us that they did not have to wait to see the dentist. One person said "There is a small wait sometimes, maximum 5 minutes."