We carried out an announced comprehensive inspection on 6 January 2017 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Advance Dental Practice is a dental practice providing predominantly private treatment for adults and children. They also provide NHS treatment for children and some patients referred via the dental access centre. Advance Dental Practice was established in 1999. The practice is both purpose built and spacious and is located on a business park. The location provides free parking and is wheelchair accessible to all patient areas.

The practice operates an extraction clinic operating on Tuesday mornings with patient assessments carried out Tuesday or Wednesday afternoons, this enabled any urgent cases to be seen in a timely manner. The purpose of this clinic is that local dentists could refer cases to the practice for a rapid service.

The practice employs one dentist, one hygienist, two dental nurses and two reception staff. Fees are displayed on the practice website.

The practice opens Monday to Friday between 9am and 5pm. They can also offer a Saturday morning appointment service by prior arrangement. There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours service. If patients called the practice when it was closed, an answerphone message gives the telephone number patients should ring depending on their symptoms.

The practice owner is also 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.

During our inspection we reviewed seven CQC comment cards completed by patients and obtained the view of three patients on the day of our inspection.

The inspection was carried out by a lead inspector and a dental specialist advisor.

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 seven patients. In addition we spoke with three patients on the day of our inspection. Feedback from patients was positive about the quality of care, the caring nature of all staff and the overall high quality of customer care. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by the principal dentist and an empowered lead dental nurse.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• Premises appeared well maintained and visibly clean. Good cleaning and infection control systems were in place and the practice followed published guidance.
• The treatment rooms were well organised and equipped, with good light and ventilation.
• There were systems in place to check all equipment had been serviced regularly, including the autoclaves and the X-ray equipment.
• The practice had a safeguarding lead professional and effective processes in place for safeguarding adults and children.
• There was a policy and procedure in place for recording adverse incidents and accidents.
• The dentist and dental hygienist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The dentist used Loupes – these enable the clinician to have a magnified view of the operation site thus enabling accuracy of treatment.
• The practice had a system to monitor and continually improve the quality of the service; including through a programme of clinical and non-clinical audits.
• Patients could access treatment and urgent and emergency care when required.
• Staff had received training appropriate to their roles and were supported in their continuing professional development by the practice owner.
• Staff we spoke with felt well supported by the practice owner and were committed to providing a quality service to their patients.
• Information from seven completed Care Quality Commission (CQC) comment cards and speaking to patients gave us a positive picture of a friendly, caring, professional and high quality service.
• The practice reviewed and dealt with complaints according to their practice policy.

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

• Review the practice web site to ensure that information is kept up to date
• Review access to interpreter services for consultations with patients whose first language is not English.