We carried out an announced comprehensive inspection on 22 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

Changing Faces Dentistry and Facial Rejuvenation at Same Day Teeth (West Midlands) Ltd is a dental practice providing general dental services on a private basis. The service is provided by two dentists and a clinical dental technician. They are supported by a dental therapist/hygienist and two dental nurses. A consultant anaesthetist visits the practice on an ad hoc basis to provide conscious sedation for nervous patients. Conscious sedation involves techniques in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation.

The practice is located in a multi-storey building and shares the building with other businesses. The whole dental practice is located on the ground floor to accommodate patients with mobility difficulties. There is wheelchair access to the practice with accessible toilet facilities (although these were out of use on the day of our visit).

The premises consist of a reception area, waiting room, two treatment rooms, a dental laboratory, an X-ray room, a decontamination room and two offices. Opening hours are from 9am to 5pm on Monday to Friday. The practice is also open on alternate Saturdays from 9am to 5pm.

The principal dentist and the clinical dental technician (CDT) operate the practice as a limited company. They are both joint directors and the principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

Thirty-five patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with three patients on the day of the inspection. Overall the information from patients was complimentary. Patients were positive about their experience and they commented that staff were helpful, friendly and professional.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding and the management of medical emergencies. We identified some areas of improvement and these were actioned promptly.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation; however, the dental care records were not sufficiently detailed to record this.
• The practice had a structured plan in place to audit quality and safety.
• Staff received training appropriate to their roles.
• Patients told us they found the staff helpful and friendly. Patients commented they felt involved in their treatment and that it was fully explained to them.
• Patients were able to make routine and emergency appointments when needed.
• The practice had a complaints process in place.
• No complaints had been received by the practice in the last 12 months.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping. However, learning points and action plans were not always documented.

• There were no dentists available on the day of our visit as they were involved in other professional commitments on the day of our inspection.

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

• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes ensuring recruitment checks, including references, are suitably obtained and recorded.
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. The practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.