We carried out an announced comprehensive inspection on 26 April 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

The Dentist@Tupsley is situated in a residential area of Hereford in a small row of commercial premises. It provides private dental care for children and adults and at the time of our inspection the practice had been open for just under a year. The services provided included the option of treatment under conscious sedation and the practice made the expected arrangements to do this safely. Conscious sedation is the use of medicines to reduce alertness and help the patient relax but still be able to hear and respond to the dentist if necessary, while treatment is carried out. Similarly, suitable arrangements were in place for dental implants and other oral surgery which the practice also provided.

The practice has two dentists, three dental nurses and an apprentice dental nurse. The dental nurses also carry out some reception duties. The practice has an administrator who is responsible for the day to day organisation of the practice and reception. One of the dentists is the provider and the other 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.

The practice has one dental treatment room and a decontamination room for the cleaning, sterilising and packing of dental instruments. There is an additional room at the practice which the provider plans to equip as a treatment room in due course as patient numbers increase. The reception and waiting areas, patient toilet, staff room and store rooms are also all on the ground floor.

The practice is open from 8am to 6pm on Mondays and Tuesdays, 11am to 7pm on Wednesdays and Thursdays and 9am to 3pm on Fridays. Appointments are available on Saturdays between 10am and 2pm by arrangement with the practice. The practice also provides 24 hour out-of-hours emergency cover.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to use to tell us about their experience of the practice. We collected 20 completed cards. We also looked at reviews 12 patients gave the practice using social media. All the information we saw provided a consistently positive view of the service the practice provides. People were complimentary about the approach of the whole practice team and the quality of service they had received. Several commented on how sensitive the practice had been to their anxiety about receiving dental treatment.

Our key findings were:

• The practice had designed and decorated the building to create a welcoming atmosphere. Several patients commented on the pleasant environment.
• The practice was visibly clean and a number of patients commented on their satisfaction with hygiene and cleanliness. The practice had 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 appropriate dental equipment and protocols to ensure they kept this well maintained and only purchased items that met recognised standards.
• Arrangements for the provision of treatment under conscious sedation and for oral surgery were in line with published guidance.
• Dental care records provided clear and detailed 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 developed governance processes to manage the practice effectively.
• The practice provided oral health education to 26 primary schools during 2015/16. The content was planned to fit with the topics being covered by children at school.

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

• Review whether there is a need to have a second oxygen cylinder as a back up.
• Review the practice's recruitment policy and procedures to provide clearer guidance about the information that needs to be obtained for each staff member in line with Regulation 19(3) and Schedule 3 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014