We carried out an announced comprehensive inspection on 22 March 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

Bank House Dental Practice is located close to the centre of Chester and comprises a reception and waiting room, six treatment rooms, all on the first floor, offices, storage and staff rooms. Parking is available outside the premises in the practice's private car park. The practice is accessible to patients with disabilities, impaired mobility but not to wheelchair users.

The practice provides general dental treatment to patients on an NHS or private basis. The practice opening times are Monday to Thursday 9.00am to 5.30pm, and Fridays 8.30am to 1.30pm. The practice is staffed by a principal dentist, a practice manager, a Foundation dentist, two hygienists, two receptionists, and six dental nurses. There are two other separately registered providers at this location and facilities and staff are shared between all three providers.

The practices’ patients are predominantly of a middle aged to elderly demographic.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

Forty people provided feedback about the service. Every comment was positive about the staff and the service. New and long-standing patients commented that they found the staff welcoming, friendly, and caring and that the practice was excellent in every respect. They said that they were always given good explanations about dental treatment and dentists listened to them and took time with them.

Our key findings were:

• The practice recorded and analysed significant events and incidents and acted on safety alerts.
• Staff had received safeguarding training and knew the process to follow to raise any concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• Premises and equipment were clean, secure and well maintained.
• Infection control procedures were in place and the practice followed current guidance.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards and guidance.
• Patients received explanations about their care, proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• We observed that patients were treated with kindness, dignity and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients and reasonable adjustments were made to enable patients to receive their care and treatment.
• Staff were supervised, felt involved and worked as a team.
• Governance arrangements were in place for the smooth running of the practice and for the delivery of high quality person centred care.
• The practice gathered the views of patients and took into account patient feedback but there was no formal system in place to obtain feedback regularly.

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

• Review the current legionella risk assessment having 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. The provider informed us after the inspection that a review is in progress.
• Review the systems and processes in place to comply with Regulations 4 to 20 of the HSCA 2008 (Regulated Activities) Regulations 2014, specifically in relation to seeking and acting on feedback from service users on the services provided, to allow continual evaluation and improvement of the service.

People who used the service told us they were given appropriate information and support regarding their treatment options and costs. They were very positive about the care and treatment they received.

People told us that consultations and treatments were undertaken in private and they felt their dignity was respected and their privacy maintained.

People spoken with also reported that appointments were flexible to meet their needs and the practice was accessible, comfortable, clean and accommodating. Some comments made were; -

“I have been coming here for many years. As have a number of my family. The service is very good.”

“Appointment times are flexible. All treatment options and costs are clearly explained.”

“The service is friendly, efficient and flexible. The treatment options are clearly explained.”

We asked the Cheshire, Warrington and Wirral Primary Care Team for information about how this service was operating. No issues of concern were reported.