We carried out an announced comprehensive inspection on 9 February 2016 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

Shawbirch Dental Practice is a mixed dental practice providing mainly private treatment with some NHS treatment for exempt adults and children. The practice has been open for about twenty five years. The practice is situated in a converted commercial property. The practice had two dental treatment rooms, a separate room with an area set aside for the cleaning, sterilising and packing dental instruments, a reception and waiting area on the ground floor.

The practice is open 9.00am to 5.30pm Monday, Tuesday, Thursday, and Wednesday 9.00am to 1.00pm and Friday 9.00am to 3.30pm. The practice has one dentist, the practice owner, and they are supported by a dental nurse. The practice has a practice manager who also acts as a senior dental nurse and receptionist. The practice also employs two part-time dental hygienists.

The practice owner is 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 33 patients. These provided a completely positive view of the services the practice provides. Patients commented on the high quality of care, the caring nature of all staff, the cleanliness of the practice and the overall high quality of customer care.

Our key findings were:

• The practice philosophy was to provide high quality patient centred care with an emphasis on the prevention of dental disease at all times.
• Strong and effective clinical leadership was provided by the practice owner.
• The practice also benefitted from a stable staff base and an empowered practice manager.
• The dentist and the other clinical staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The dentist acted as the safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• A system was in place to report incidents with practice meetings used as a vehicle for shared learning.
• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment, urgent and emergency care when required.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).
• Staff we spoke to felt well supported by the practice owner and were committed to providing a quality service to their patients.
• Information from 33 completed Care Quality Commission (CQC) comment cards gave us a completely positive picture of a friendly, caring, professional and high quality service.
• The practice received no complaints in 2015.

The practice had completed a series of regular audits to ensure that the quality of care was maintained at all times.

As part of our review we spoke with seven people who used Shawbirch Dental Practice to gain their experiences of the service they received. These people included people who were nervous, had received extensive treatment, had mobility difficulties, were new or had attended the practice over a number of years. Everybody we spoke with said they were ‘very’ satisfied with the service they received. They said they would and had recommended the practice to their family and friends.

People told us that they were made welcome and were always treated with respect and their dignity and privacy was upheld. Staff shared examples of how they maintained confidentiality within the open plan reception and waiting area and we saw this in practice. People told us the staff knew them well and they were regularly asked about any changes to their medical health prior to receiving their check up or treatment.

People said the dentist was very gentle and fully involved them in their treatment. They said their examinations and treatment were thorough and included regular checks such as soft tissue and x-rays. People told us they were always given time away from the practice to consider their treatment options and any costs involved. One person who had extensive treatment told us the dentist had explored and recommended treatment that met their needs and was within their budget. People said they always received a copy of their treatment plan and an estimate of costs. Discussions held and records we sampled evidenced that people were not given any unnecessary treatment.

People we spoke with said the practice was ‘always’ spotlessly clean. They said staff wore personal protective clothing such as gloves and eye protection. They told us staff were sensitive to their individual needs, for example a person with mobility difficulties told us the practice suited them as the surgery was on the ground floor. They said they were always given an appointment at a time that suited them and they were able to remain in their wheelchair for routine check ups. If they needed to transfer to the dentist chair they were given time and never rushed.

The practice had arrangements in place in the event of a medical emergency and staff had received annual refreshers to keep their skills and knowledge up to date.

The staff were open and demonstrated a positive and enthusiastic approach to their

work. The dentist told us he was proud of his dentistry and the people he saw were motivated and educated about their dental health.