We carried out an announced comprehensive inspection on 24 November 2015 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

Epworth House Dental Practice is situated on the edge of Worcester city centre in a residential street. The practice provides NHS and private treatment and carries out dental implant treatment for their own patients and for patients referred to them by other practices.

The practice has five dentists, a dental hygienist, and nine dental nurses. The clinical team are supported by a practice manager and a team of reception staff. The head receptionist was also a dental nurse. The practice has five dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments. The reception area, main waiting room and two treatment rooms are on the ground floor.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to tell us about their experience of the practice. We collected 67 completed cards and two other notes left by patients in our comments box. Patients were positive about the practice and their experience of being a patient there. People described receiving a flexible, respectful and helpful service. Many made complimentary remarks about the approach of the dentists and other members of the practice team, and the standard of treatment they received. Some patients specifically mentioned that their dentists listened to them attentively and explained their care and treatment in a way they understood. Two patients commented that they would like more frequent check-ups and scale and polish appointments and said that they had experienced appointments being cancelled at short notice.

Our key findings were:

• Patients were pleased with the care and treatment they received and complimentary about the whole practice team.

• The practice had an established process for reporting and recording significant events and accidents to ensure they investigated these and took remedial action. The practice used significant events to make improvements and shared learning from these with the team.
• The practice was visibly clean and a number of patients commented on their satisfaction with hygiene and cleanliness.
• The practice had well organised systems to assess and manage infection prevention and control.
• The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• The practice had recruitment policies and procedures and used these to help them check the staff they employed were suitable.
• Dental care records provided the necessary information about patients’ care and treatment.
• Staff received training appropriate to their roles and were supported in their continued professional development.
• Patients were able to make routine and emergency appointments when needed.
• The practice had a complaints policy and procedure and evidence to show they dealt with complaints. 
• Although there was a management structure we found that there was overlap of responsibilities in some areas of practice management which were not clearly defined.
• The practice had systems including audits to assess, monitor and improve the quality and safety of the services provided.
• The practice had systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors.
• The practice used social media as an additional way to communicate information to patients. One of the dental nurses was delegated the role of keeping the practice’s social media profiles up to date and was positive and enthusiastic about the contribution this made to communicating effectively with patients.
• The practice had asked their team to reflect on how the practice provided safe, effective, caring, responsive and well led services in line with the areas we look at in our inspections. Staff had spent time considering and analysing how they and the team worked together to achieve positive outcomes in all these areas. It was positive to see that many of the staff provided examples of their previous or planned future contributions to this.

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

• Review the management structure to ensure all roles and responsibilities are clearly defined.

We spoke with four people who were using the service at the time of our inspection. We also spoke with one person who was registered with the practice by telephone. We spoke with the registered provider and the practice manager as well as seven dental nurses.

People who used the practice told us that they were happy with the quality of treatment received. One person told us, “My treatment was fantastic, the best. Everything’s very good from the receptionists up. It couldn’t be better.” Another person said, “It’s a very nice practice. I wouldn’t go anywhere else. They’re all very friendly.”

People felt they were given enough information about their treatment options and the relevant fees, and were able to ask all the questions they wanted to.

People were protected from the risk of abuse because staff had been trained how to recognise signs of abuse and knew how to report concerns.

We found that people received care and treatment in a clean and hygienic environment. People we spoke with had no concerns about the cleanliness of the practice.

We found that staff were supported to deliver care and treatment safely and to an appropriate standard.

We looked at records which showed that the provider was regularly monitoring the quality of its service.