We carried out an announced comprehensive inspection on 17 November 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.

Background

The practice is situated in Heswall, an affluent area of Wirral. The practice has been refurbished to a high standard. The practice has one principal dentist, an associate dentist, three dental hygienists, a practice manager, six qualified dental nurses and a receptionist. The practice provides primary dental services to private patients only. The practice is open Monday – Thursday 8.30am – 5pm, and Friday 8.30am -1pm

The principal dentist is the registered provider. A registered provider is registered with the Care Quality Commission to manage the service. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We received feedback from 49 patients about the service. The comment cards seen and patients spoken to reflected positive comments about the staff and the services provided. Patients commented that the practice appeared very clean and they found the staff very caring and friendly. They had trust and confidence in the dental treatments and said explanations from clinicians were clear and understandable. Emergency appointments were available on the same day and appointments usually ran on time.

Our key findings were:

• The practice recorded and analysed accidents, incidents and complaints and cascaded learning to staff when they occurred.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and emergency equipment were available.
• Infection control procedures were in place.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and their confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice staff felt involved and worked as a team.
• The practice took into account any comments, concerns or complaints and used these to help them improve.

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

• Improving the significant clinical event reporting system to distinguish between clinical events and accidents.
• Review how patient safety and other relevant alerts and guidance are followed and actions taken are recorded.
• Reviewing and updating policies and procedures including recruitment policies and procedures to ensure they meet relevant guidelines and legislation.
• Obtaining and assessing written references for newly employed staff.
• Storing temperature sensitive materials in an appropriate fridge that is monitored and maintained to ensure it remains effective.
• The use of an illuminated magnifying glass to inspect dental equipment after cleaning.
• Obtaining documented evidence of clinical staff’s immunisation status.
• Implementation of a business continuity plan.
• Undertaking regular fire safety training and fire drills.

The White House Dental Practice had an accessible guide to services for new and existing patients; this provided comprehensive information about services offered at the practice, details of the payment plan and emergency cover.

We found that the patients receiving treatment were informed as to the options and course of treatment needed, including the cost of the treatment. Consent to treatment had been obtained in all cases before treatment commenced. All staff working in the practice had attended regular training including cardio-pulmonary resuscitation (CPR) and safeguarding training, all had relevant criminal record bureau disclosure checks (CRB’s). During our visit we found that the practice had thorough hygiene practices and quality auditing. There was an effective complaints procedure available to patients using The White House Dental Practice.