We carried out this unannounced inspection on 3 July 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 inspector who was supported by a specialist dental adviser.

We told the NHS England area team that we were inspecting the practice. They provided information which we took into account.

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

Bradley and Partners is in Canterbury and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including some for patients with disabled badges, are available near the practice.

The dental team includes 10 dentists, seven dental nurses, two student nurses, three dental hygienists, three receptionists, a compliance manager and a practice manager. The practice has 10 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. The registered manager at Bradley and partners was the compliance manager.

On this occasion we did not supply CQC comment cards to be filled in by patients as this was an unannounced inspection.

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

The practice is open:

8am to 5.30pm Monday to Friday

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• 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 practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice 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.
• The appointment system met patients’ needs.
• 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. They should:

• Review current processes to ensure that all mandatory training has been completed in subjects such as, infection control, radiography, safeguarding vulnerable adults and children and the Mental Capacity Act.
• Review current processes to ensure that records are maintained consistently with regard to the equipment used to carry out decontamination procedures.

We carried out an announced comprehensive inspection on 24 March 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

Bradley and Partners is located in the city of Canterbury and offers general dentistry services to NHS Patients and private treatment options are also available. The practice has eleven dentists, three hygienists who are supported by a practice manager, fifteen dental nurses and four receptionists. The practice also has the services of three dental technicians who work from the practices dental laboratory.

The practice has ten treatment rooms, over three floors. Spacious reception and waiting areas, decontamination room and staff facilities.

The practice is open: Monday – Friday 8.30am to 5.30pm and Saturdays 9am to 1pm

One of the dentists is the registered manager. 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.

On the day of inspection we received 47 CQC comment cards providing feedback and spoke to nine patients. The patients who provided feedback were very positive about the care and attention they received at the practice. They told us they were involved in all aspects of their care and found the staff to be excellent, great at responding to pain requirements, helpful and they were treated with dignity and respect in a clean and tidy environment.

Our key findings were:

• Patient care and treatment was planned and delivered in line with evidence based guidelines, best practice and current regulations.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were consistently involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs. Appointments were easy to book and emergency slots were available each day for patients requiring urgent treatment.
• There was a complaints system. Staff recorded complaints and cascaded learning to staff.
• The governance systems were effective.
• The practice sought feedback from staff and patients about the services they provided.
• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Strong and effective leadership was provided by the principal dentist.
• Infection control procedures were robust and carried out in accordance with current guidance

The practice was clean, spacious and very well maintained.