People told us that they had been given a choice of treatments telling us ” I am able to make choices either at the time or think about things and let them know my decision”.

All of the people we spoke with said that they had the costs of their treatment explained to them, and that these were itemised especially in a longer course of treatment”.

We spoke with three people who were attending the practice for treatment on the day of our visit. They all told us that staff at the practice were friendly and that “I’ve always found it excellent here”. We spoke with one person who was attending the practice as an emergency, they told us: ”I rang this morning for an emergency appointment and was fitted in”. One person told us that they were having treatment at their appointment and the dentist had explained everything to them. They said they were nervous, but that the dentist was “excellent” and they did all they could to make them feel relaxed.

The purpose of this inspection was to find out the answers to five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection; we sought information about people’s experience and gained views from people who used the service, their relatives, the staff who supported them and from looking at records.

We spoke with the practice manager, two dentists, three dental nurses and two receptionists. In addition we had the opportunity to ask nine people, who attended the practice during our visit, about their care and treatment.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

People we spoke with had been using the practice for varying lengths of time from less than a year, to twenty years. Those who had used the practice for a long time stated that this was an indication of their satisfaction. They all described the staff positively. People said that the staff were “friendly”, “Always friendly and helpful” and “Very friendly and understanding”.

We looked at the computerised records for four people who attended the practice. They recorded people’s personal details and medical history along with clinical notes and charts to record the treatments they had.

Clinical notes showed that there had been a check of people’s gum health and soft tissue. Where treatment was provided there was a description of the need for treatment, a record that the person had given consent and the type of treatment they chose. When anaesthetic was used the type, dose and expiry date were recorded. There were similar records when products were used for fillings or impression taking. In one person’s clinical notes we saw how the process of a root canal treatment was described including the tools used.

Is the service responsive?

Emergency appointments were included in the calendar each day for people who needed urgent treatment. Two people told us they had telephoned the practice that day for an emergency appointment and were pleased that the practice was able to respond.

Staff completed training in dealing with medical emergencies and Cardio Pulmonary Resuscitation (CPR). Emergency medicines, oxygen and an automatic external defibrillator were kept as recommended by the Resuscitation Council UK.

Is the service safe?

We saw the provider's consent policy. It outlined that the practice recognised people’s right to decide what happened to them and that they had the right to refuse advice or treatment. It listed what discussions with people should include prior to treatment commencing including, why the dentist felt the treatment was necessary. We observed this in the records we looked at

The premises were well maintained and guidance had been followed in respect of preventing the risk of infection.

Is the service effective?

The principal dentist and practice manager told us the practice referred people to other ‘specialist’ service providers for more complicated endodontic treatments (root canal fillings) and orthodontics (tooth alignment).

Is the service well-led?

The practice manager, who also managed the providers other practice in Yate and the one in Winterbourne, showed us how they were in the process of updating the policies folder. The folders were divided into sections to match the ‘Essential Standards of Quality and Safety’. These were produced by the Care Quality Commission as guidance to providers of regulated services about how to comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

When we looked at the policies folder, we saw that the manager was gathering evidence so that they were able to demonstrate compliance.