We spoke with four patients during our visit. Patients told us staff were helpful and always treated them respectfully. One patient said: "It is top notch here” and another told us: "I think the practice is fabulous.”

We looked at four patient's records which were available on a computer system. These contained all the relevant clinic information to show a full oral health assessment had been carried out. We found that the practice had the necessary equipment and medication for dealing with medical emergencies.

We saw the practice had a separate decontamination room and that the relevant guidance for cleaning instruments was followed. We found evidence to demonstrate that staff were supported by means of staff meetings and training suitable for their role. We saw evidence that the practice had complaints policies and procedures in place and complaints were dealt with appropriately.

We carried out this announced inspection on 20 February 2018 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 Cheshire and Merseyside area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

Bupa - Park Street, Chester is close to the centre of Chester and provides dental care and treatment to adults and children on an NHS and privately funded basis.

The provider has a portable ramp available to facilitate access to the practice for wheelchair users and for pushchairs. The practice has four treatment rooms. Car parking is available at the practice.

The dental team includes three dentists, a dental hygienist, two dental nurses and a receptionist. The team is supported by a practice manager.

The practice is owned by a company and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Bupa - Park Street, Chester is the practice manager.

We received feedback from 13 people during the inspection about the services provided. The feedback provided was positive about the practice.

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

The practice is open:

Monday to Thursday 8.00am to 7.00pm

Friday 8.00am to 4.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• The practice had systems in place to help them manage risk.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had staff recruitment procedures in place. We were not provided with evidence that references were obtained prior to employing staff.
• The provider had procedures in place for reporting and investigating accidents. We observed that these had not previously been followed correctly.

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

• Review the practice’s system for the recording, investigating and reviewing of accidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes ensuring references are obtained and suitably recorded.