We carried out an announced comprehensive inspection on 9 March 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.

Background

Clarendon Dental Spa is situated in Leeds, West Yorkshire. The practice provides dental treatment to adults and children on an NHS or privately funded basis. The services include preventative advice and treatment, routine restorative dental care, dental implants, orthodontics, oral surgery, paediatric dentistry and treatment under conscious sedation. The practice accepts NHS referrals for paediatric dentistry, oral surgery and orthodontics.

The practice has 11 surgeries, a decontamination room, two waiting areas, an X-ray room, a patient consultation room and a reception area. Facilities are spread over three floors. There are accessible toilet facilities on the ground floor and a secure car park at the rear of the premises.

There are 20 dentists (many who are part-time), one dental hygienist, 11 dental nurses, one head receptionist, a patient liaison manager, a referrals manager and a practice manager. Some of the dentists were on a specialist register including paediatric dentistry, restorative dentistry, orthodontics, oral surgery and special care dentistry.

The opening hours are Monday and Wednesday from 9:00am to 5:30pm, Tuesday and Thursday from 10:00am to 8:00pm and Friday from 9:00am to 4:00pm.

The practice owner 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.

During the inspection we spoke with 12 patients who used the service and reviewed 33 completed CQC comment cards. The patients were positive about the care and treatment they received at the practice. Comments included staff were friendly, welcoming and polite. They also commented details of treatment were well explained, staff listened to their concerns and the practice was bright, clean and hygienic.

Our key findings were:

• The practice was visibly clean and uncluttered.
• The practice had systems in place to assess and manage risks to patients and staff including health and safety and the management of medical emergencies.
• Staff were qualified and had received training appropriate to their roles.
• Patients were involved in making decisions about their treatment and were given clear explanations about their proposed treatment including costs, benefits and risks.
• Dental care records showed treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• We observed patients were treated with kindness and respect by staff.
• Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood.
• The practice had a complaints system in place and there was an openness and transparency in how these were dealt with.
• Patients were able to make routine and emergency appointments when needed.
• The governance systems were effective.
• There were clearly defined leadership roles within the practice and staff told us they felt supported, appreciated and comfortable to raise concerns or make suggestions.

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

• Review the use of closed-circuit television (CCTV) in the practice, specifically in the treatment rooms.
• Review the practice's protocols for completion of dental records in relation to conscious sedation giving due regard to the Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015’.
• Review its audit protocols to ensure the X-ray audit is practitioner specific.
• Review its responsibilities to the needs of people with a disability and the requirements of the Equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.