We carried out an announced comprehensive inspection on 2 August 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

Ward End Dental Practice is a dental practice providing general dental services on a NHS and private basis. The service is provided by six dentists. They are supported by seven dental nurses (five of whom are trainees), a practice manager and a receptionist. The practice manager is also a qualified dental nurse.

The practice is located on a busy road close to local amenities and several bus routes. There is a large car park with a dedicated bay for patients with disabilities. There is ramp access to the premises for people that use wheelchairs, pushchairs and bicycles. The premises consist of a waiting room, a reception area, two treatment rooms, an office, a kitchen, a decontamination room, a private consultation room and accessible toilet facilities on the ground floor. The first floor comprises of a second kitchen, additional toilet facilities, two treatment rooms, a disused treatment room and two storage rooms. There was also a locked room that was rented to a therapist who carried out beauty treatments. Opening hours are from 9am to 6pm from Monday to Friday.

The practice manager 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.

Thirteen patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with four patients. Overall the information from patients was complimentary. Patients were positive about their experience and they commented that staff were friendly and polite.

Our key findings were:

• The practice appeared clean and tidy on the day of our visit. Many patients commented that this was also their experience.

• Feedback from patients described the service as friendly and polite. Patients were able to make routine and emergency appointments when needed, although some commented that waiting times needed to be improved.

• The practice carried out effective infection control procedures in line with current guidance. Some shortfalls were identified and most were resolved promptly.

• The practice had systems to monitor and manage risks to patients, staff and visitors. This included infection prevention and control, health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. Some improvements were required and most were actioned promptly.

• Patients’ care and treatment was planned and delivered in line with evidence based guidelines and current legislation.

• Staff received training appropriate to their roles.

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.

• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.

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

• Review availability of medicines and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK) and the British National Formulary.
• Review stocks of medicines and equipment and the system for identifying and disposing of out-of-date stock. They should also review their processes for identifying when essential equipment maintenance checks are due so that they are carried out in a timely manner.
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections' and related guidance.

People attending Ward End Dental Practice on the day of our visit told us they were happy with the service they received. They told us all treatment was explained to them and the choices they made were respected.

People told us the dentist and dental nurses at the practice made them feel at ease and this helped with any anxieties that they had.

People we spoke with said everything always looked clean.

Some direct quotes from people who had received treatment at the dentist told us:

"Very good dentist''

“They always see me when I want them too, nothing is ever too much trouble''.

" The waiting time are a problem we have to waite too long''.

" They need to address the time people have to wait''.

During this inspection we spoke with the practice manager and staff. We also conducted telephone interviews with five people who used the service.

We found that people had the information they needed to help them make informed choices about their treatment. One person told us, "The treatment plan was explained properly". People told us that they had no concerns about the care and treatment that they received. One person said, "It's very good, I am pleased with my treatment".

We found that people received care and treatment in a clean and hygienic environment. People that we spoke with had no concerns about the cleanliness of the environment. One person told us, "It's always clean".

People that we spoke with were complimentary about the staff working at the dental practice. We found that staff were trained and supported to deliver care and treatment to an appropriate standard.

We found that the provider had systems in place to ensure that people receive a quality service. People that we spoke with confirmed that the treatment they received was of good quality.