We carried out an announced comprehensive inspection on 10 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Kingswood dental centre is a dental practice providing mainly NHS treatment for adults and children. The practice is based close to local shops and has car parking at the rear of the practice. The practice lease the building and treatment rooms are on both the ground and first floor.

The ground floor consists of a waiting area with open reception, two patient toilets one of which is wheelchair accessible, one treatment room and a separate room for staff. On the first floor there were four treatment rooms, a small office and a room for sterilising and packing of dental instruments. The practice have a ramp to the rear of the premises for people who use a wheelchair.

The practice employs seven dentists, one of whom was also a regional dentist whose role was to provide clinical support to staff at other practices. There were four dental nurses and two trainee dental nurses, one hygienist, four receptionists and a practice manager.

The practice opens: Monday to Wednesday 7.30am to 7.30pm, Thursday 8.30am to 7pm, Friday 9am to 5pm, Saturday: Closed, Sunday: Closed.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This out-of-hours service is accessed by calling NHS 111.

The practice manager is also 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.

Before the inspection, we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from nine patients. In addition we spoke with two patients on the day of our inspection. Feedback from patients was positive about the quality of care, the caring nature of all staff and the overall high quality of customer care. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Our key findings were:

• We found the dentists’ approach to treatment was to provide patient centred dental care in a relaxed and friendly environment.
• The dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Premises appeared well maintained and visibly clean.

• Infection control procedures were effective and the practice followed published guidance.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• Although the dentists and hygienist provided effective clinical care leading to good patient outcomes, there were shortfalls in some of the clinical records checked and one member of the dental team was reluctant to have chairside support when treating patients.
• There were systems in place to check all equipment had been serviced regularly, including the autoclaves.
• The practice had a system to monitor and continually improve the quality of the service. This included a programme of clinical audits.
• Patients could access treatment and urgent and emergency care when required.
• Information from nine completed Care Quality Commission (CQC) comment cards and two patients we spoke with gave us a positive picture of a friendly, caring and professional service.
• The practice carried out pre-employment recruitment checks in accordance with the regulations.
• The staff had received training relevant to their role.
• There were arrangements for identifying the ongoing learning and development needs of staff members and the on-going assessment and supervision of staff employed.
• The practice reviewed and dealt with complaints according to their practice policy.

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

• Review their arrangements for monitoring that dental care records are maintained appropriately giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review audit outcomes to demonstrate learning points identified and the resulting improvements implemented.
• Review the arrangements for chairside support in line with guidance issued by the General Dental Council (GDC) standards for the dental team. On the occasions where chairside support is refused or is not provided, document the risks, rationale and reasons in the patient record.