We carried out an announced comprehensive inspection on 20 February 2017 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.

Bramingham Dental Clinic is a mixed NHS and private practice in Leagrave, near Luton in Bedfordshire. The practice offers a range of general dental treatment. The premises are located on the first floor and consist of five dental treatment rooms, a reception and waiting area and a separate decontamination area.

The staff at the practice consist of two principal dentists, five associate dentists, a practice manager, a Care Quality Commission (CQC) administrator, a dental hygienist, two dental nurses, six trainee dental nurses and five receptionists.

One of the principal 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.

Our key findings were:

• There was an induction programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and the dentist took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• The practice placed an emphasis on the promotion of oral and general health and the prevention of dental disease. Appropriate information and advice was available according to patients’ individual needs.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received assessments of their oral health needs. They were given clear explanations about their proposed treatment, and its costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring, very welcoming and worked well as a team.

• There was an effective system in place to act on feedback received from patients and staff.
• We reviewed 15 Care Quality Commission (CQC) comment cards that had been completed by patients prior to our inspection. Common themes were patients felt they received excellent care in a calm and hygienic environment from staff who were caring, reassuring and informative. Several patients specifically commented how staff had been particularly supportive with their anxieties and had taken time to put them at ease.

During our inspection of Bramingham Dental Clinic on 27 September 2013, the people we spoke with said they were regularly asked to consent before proceeding with any dental examinations or treatment. They said they proceeded with a full understanding of what they were agreeing to. They said their medical histories were checked regularly. Our review of records showed that people's consent and medical histories were checked and well recorded and people received regular basic dental examinations.

From our conversations with people and staff and our review of records, we found that staff were appropriately registered and qualified and had been subject to an adequate recruitment process. The staff we spoke with demonstrated a good knowledge and understanding of the equipment used at the service. The records we looked at showed the equipment was serviced, maintained and tested, and was fit for purpose.

We saw the service had a complaints process in place and complaints people made were responded to appropriately. Our observations and review of documentation showed the service had sufficient arrangements in place to deal with foreseeable emergencies.

One person using the service said: "I highly recommend it here. Nothing is too much trouble it seems." Another person said: "I've already recommended it to several friends who have come and been very happy with it."

During our visit to this surgery on 20th January 2012 we spoke with six people who were waiting to see one of the dentists or the hygienist. People told that they were treated well. One person said, “I choose to come here, because I came with a friend and they were so good to her”. Another person said, ”they explain what they are going to do and I can say what I want”.

People told us that the dentist always explained their treatment to them and talked to them about oral health. People told us that they felt confident to speak to the dentist and other staff at the surgery and to ask questions about their treatment.

We were told by a patient that the “building is always spotless, but it does not look clinical which makes me relax more”.

People told us that the staff team were kind, friendly and approachable. One person said, “Everyone working here appears to know what they are doing and they all look as though they enjoy their jobs”.