Bewdley Dental Practice is owned by two dentist partners and also has three associate dentists who work part time, eight qualified dental nurses who are registered with the General Dental Council (GDC), four dental hygienists, a practice manager and a part time receptionist. The practice’s opening hours are from 8.15am to 5.30pm Monday to Thursday and from 8.15am to1pm on Friday. The practice is closed between the hours of 1pm to 2pm Monday to Thursday.

Bewdley Dental Practice provides NHS and private treatment for adults and children. The practice is situated in a converted property. The practice has five dental treatment rooms; two on the first floor and three on the second floor and a separate decontamination room for cleaning, sterilising and packing dental instruments. There is also a reception and two waiting areas, one on each floor.

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 collected 36 completed cards and spoke with three patients.

Our key findings were:

• The practice had mechanisms in place to record significant events and accidents.

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, responding to medical emergencies and maintaining equipment.

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

• There were sufficient numbers of suitably qualified staff to meet the needs of patients.

• Patients were treated with dignity and respect and their confidentiality was maintained.

• The practice was visibly clean and well maintained.

• Options for treatment were identified and explored and patients said they were involved in making decisions about their treatment.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• Health promotion advice was given to patients appropriate to their individual needs such as smoking cessation or dietary advice.

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

• Staff received training appropriate to their roles and told us they felt well supported to carry out their work.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

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

•  Review procedures to ensure learning points from incidents and complaints are shared with all relevant staff and any improvements demonstrated.

• Register with the MHRA to receive medicine safety alerts and ensure that any alerts relevant to the practice are discussed with staff and actions taken as appropriate.
• Review the storage arrangements for temperature sensitive medicines ensuring they are stored in line with manufacturers ‘instructions.
• Review that the practice’s infection control practices to ensure that when staff are manually cleaning dental instruments they visually inspect all items under an illuminated magnifier to ensure they are clean in line with the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.

• Review documentation use for fire safety checks at the practice and ensure that staff who complete these checks sign to confirm that they have done so.

• Undertake reviews and audits of consent and provide consent records that contain full details of conversations held.

• Implement a stock control system with documentation to enable staff to be aware of medicines available at the practice at all times.

• Establish and operate an effective staff appraisal system which enables to staff to raise issues or concerns and to receive feedback about their work at the practice. Personal development plans should be included within the appraisal process.
• Implement a system to ensure that dental care record audits are undertaken to help improve the quality of service. 

During this inspection we spoke with the practice manager, the principal dentist and one dental nurse. We spoke with one person who used the practice on the day of our inspection and we spoke on the telephone with five people who used the practice.

People felt they were given enough information about their treatment options and the relevant fees. People felt involved in the choice of treatments they required. One person said: “They are fabulous. I always know what the dentist is going to do”.

People that used the practice told us they were very happy with the quality of the information, care and treatment they received. One person we spoke with said: “They are very good. This is the best one yet”. Another person we spoke with said: “We are very satisfied with the service”.

The practice was clean and hygienic. People we spoke with confirmed that this was their experience too. There were suitable arrangements made for the cleaning, sterilising and storing of instruments so that people were not placed at risk of infection.

We looked at the recruitment process in place. We were able to see that appropriate checks were not always carried out before staff commenced employment.

The provider had systems of audits in place to enable them to monitor the quality of the service provided. This made sure that people received appropriate care and treatment.