During our last inspection in October 2013 we found that patients were not always respected with regard to cancelled appointments, and the staff were not fully supported to carry out their role.

The provider sent us an action plan outlining what steps they would take to improve the service they delivered.

We found the manager had carried out all the actions they said they would. This included written guidance and procedures for staff to follow when having to cancel patient appointments.

Patients were also informed when dentists left or joined the practice and we saw a copy of a letter that was sent to patients giving them choices about their future treatment.

We found that staff had completed all training the provider deemed as essential. This included annual training in safeguarding and information governance.

A programme of annual staff appraisals had been implemented and was being completed by all staff. We saw that the staff were given opportunities to discuss their career development.

We found that patients were respected and involved in their treatment and that staff were supported through training and appraisal.

During and after our visits we spoke with nine patients. One patient told us that at previous visits they had felt rushed and had not always understood the information from the dentist. They went on to explain that on the day of our visit they had seen another dentist who they described as: “Brilliant, they were particularly good”. Three of the people we spoke with had experienced cancelled appointments and for one person this had happened twice in one week and also to a member of their family.

One of the dental nurses we spoke with explained accurately the processes and procedures in place to decontaminate instruments. The practice manager described the checks they carried out to ensure that decontamination equipment was functioning properly. We saw records of the checks that were made by staff.

We had concerns that trainee staff were not adequately supported. All the staff we spoke with told us they worked well together and that nursing staff helped each other with procedures they were unfamiliar with. Two of the dentists we spoke with told us that they felt trainee dental nurses did not have sufficient training before being expected to work without supervision in the surgery.

The provider’s compliance manager carried out audits of the practice. They told us that their latest audit had highlighted the need for better stock control and organisation of the stock room. This was also raised by some of the staff who told us that they had, at times, run out of materials and would like a greater choice of materials. We saw that the practice had an action plan in place to address the stock control issues.