We carried out an announced comprehensive inspection on 20 January 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

The practice is situated in Hoylake, an affluent area of Wirral. The practice has been refurbished to a high standard. The practice has one principal dentist, two dental hygiene/ therapists, one qualified dental nurse, one trainee dental nurse and a receptionist. The practice provides primary dental services to private and NHS patients. The practice is open Monday 9am – 7pm, Tuesday 9am – 6pm, Wednesday 9am – 6pm, Thursday 9am – 7pm, Friday 9am – 5pm and Saturdays by appointment.

The principal dentist is the registered provider. A registered provider is registered with the Care Quality Commission to manage the service. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We received feedback from 26 patients about the service. The 21 comment cards seen and five patients spoken to reflected very positive comments about the staff and the services provided. Patients commented that the practice appeared very clean and tidy and they found the staff very caring, friendly and professional. They had trust and confidence in the dental treatments and said explanations from clinicians were clear and understandable. Emergency appointments were available on the same day and appointments usually ran on time.

Our key findings were:

• The practice recorded and analysed accidents, incidents and complaints and cascaded learning to staff when they occurred.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and emergency equipment were available.
• Infection control procedures were in place.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and their confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice staff felt involved and worked as a team.
• The practice took into account any comments, concerns or complaints and used these to help them improve.

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

• Implementation of formal documented meetings at which information exchange regarding safety and effective, responsive care of patients is disseminated to all staff.
• Implementation and monitoring of a general housekeeping cleaning schedule.
• Implementation of a staff appraisal and development process.

We spoke with two patients they told us they were given appropriate information about their treatment options. They also told us all consultations and treatments were undertaken in private and they felt their dignity was respected and their privacy maintained.

Patients were asked to complete a health declaration form. They then discussed this information privately with their dentist. We looked at four treatment plans that recorded detailed information about consultations including dental/medical history, examination, treatment options and costs.

The practice had a copy of the local area adult and child safeguarding policy and procedure in place including contact details. They also had guidance information for the staff team to refer to.

The treatment rooms were clean, free from clutter with surfaces that could be cleaned and disinfected between patients. There were supplies of protective equipment such as glasses and aprons for use by both patients and staff. Patients spoken with made the following comments:

"Everywhere is very clean and the waiting room is very comfortable."

"My dentist and the nurse always wear gloves, I am given protective glasses."

Information provided by the provider showed staff received an induction to ensure they had the skills and knowledge to support the patients who used the service. We spoke with two members of staff who said they were given good training opportunities.