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We carried out an announced comprehensive inspection of this service on 26 October 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.

Queens Road Dental and Cosmetic Centre provides predominantly (99%) NHS treatment with a small amount (1%) of private treatments.

The practice opening times were displayed in the practice and in the patient leaflet. The practice was open Monday to Wednesday from 9am to 5.30pm, Thursday from 9am to 7pm, Friday from 9am to 5pm and Saturday from 9am to 1pm.

The staff structure of the practice consists of one dentist and a dental therapist who are supported by four registered dental nurses who work part time and two trainee dental nurses. The dental nurses also cover the reception desk. One of the dental nurses is training to become a dental hygienist.

The dentist is the registered person. 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.

There was a reception desk separate to the waiting area, two treatment rooms were on the ground and first floor. There was also a separate decontamination room. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and oral hygiene.

Before our inspection we left CQC comment cards and asked patients to share their views and experiences of the service. We received 21completed comment cards all of which reflected positive comments about the staff and the services provided. Patients commented on the newly refurbished premises, the cleanliness and approachability of staff.

We also spoke with four patients attending the practice for appointment. Each patient told us they were involved in treatment planning and given enough information to make choices.

Our key findings were:

• Effective safeguarding processes were in place relating to child protection and safeguarding adults and who may be vulnerable.

• There were systems in place to ensure equipment was serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray set.

• The practice supported staff to maintain the necessary skills and competence to meet the needs of patients.

• Oral health assessments and planned treatment was carried out in line with current best practice guidance or example from the Faculty of General Dental Practice (FGDP).

• Patients were able to make routine and emergency appointments when needed. There was information for patients explaining how to access emergency treatment when the practice was closed.

• There was a wide range of policies and procedures in relation to health and safety and safe working practices. However the policies were not dated so it was difficult for us to know when they were written.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice sought feedback from staff and patients about the services they provided.

• Patients commented that they felt the practice offered an excellent service and staff were polite, helpful, caring and treated them with respect.

• The practice did not have all the equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team. The dentist had placed on order to purchase these items during the inspection and we received confirmation that it had been received in the surgery the day after the inspection.

• There was a business continuity plan detailing the arrangements in place to manage unexpected events that may disrupt the running of the practice.

• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.

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

• Ensure the clinical waste bin in the yard is securely locked to prevent the risk of contaminated materials being accessed.

• Review the accessibility of the air compressor in the first floor treatment room. Compressor and dryer plant should ideally be installed in a well-labelled, locked, dust-free, dry, cool, well-ventilated room.

• Update the local rules to reflect the recommendations of the Radiation Protection Advisor.

• Monitor and record fridge temperatures to ensure dental equipment and medicines remain effective.
• Ensure there is a written record of the daily and weekly checks of emergency equipment and medicines in line with the Resuscitation Council guidelines.