We visited the provider to follow up on areas of non-compliance identified at our previous visit on 22 February 2013. At our previous visit we found that the provider did not regularly seek the views of patients for feedback on the service. We found that the provider did not operate a system of appraisal and supervision to ensure that learning and development needs for staff were identified. We also found that records for staff and the management of the practice could not be located promptly. The provider wrote to us with an action plan and told us that they would take action by November 2013.

During our visit on 7 November 2013 we saw that all three members of employed staff had received an appraisal. We saw that gaps in training had been identified and each member of staff had a personal development plan. We saw that the provider had introduced a patient satisfaction survey which was available in the waiting room for patients to fill in at their leisure. We saw that 11 completed surveys had been received and the results had been analysed. As a result of patient feedback the practice information leaflets had been placed more visibly on display in the waiting room.

We saw that the practice had implemented a new records management system. We saw that records relating to staff and the management of the practice we filed in an organised system, in a single place and were quickly available upon request.

We spoke to three patients who received treatment on the day of our visit. All the patients we spoke to were very satisfied with the quality of care received. One patient said "they received a very good standard of care". This patient travelled over thirty miles to visit the practice because of the quality of care received. Another said "the dentist knows what he is doing and is very professional".

The three patients commented on how friendly and caring the practice staff were. One patient said the practice staff are "really lovely and helpful".

All three patients commented on the cleanliness of the practice. We found the practice clean and tidy. One patient said the cleanliness is always very good and said "there are no issues". All three people we spoke to would recommend the practice to their family or friends.

We found that all three patients were given appropriate information and choices about their treatment options and the associated costs. One patient commented that prevention was mentioned and described the approach from the practice as "preventive maintenance". This was confirmed when reviewing clinical records.

We found that staff were not supported in identification of their learning needs to ensure their professional development was met.

Patients were not able to express their views of the way the service was run in relation to their care and treatment.