We carried out an unannounced comprehensive inspection on 27 January 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

Bhandal Dental Practice has 17 dentists, 30 qualified dental nurses who are registered with the General Dental Council (GDC) and three dental therapists. A number of dental nurses work as ‘bank’ staff and may be required to work at other Bhandal dental surgeries. The practice’s opening hours are from 7.30am to 6pm Monday, Tuesday, Wednesday and Friday, 7.30am to 8pm on Thursday and 7.30am to 1pm on Saturday. The practice is closed between 1pm and 2pm Monday to Friday.

Bhandal Dental Practice provides NHS and private treatment for adults and children. The practice is situated in a converted property. There are twenty dental treatment rooms; seven on the ground floor and 13 on the first floor. There are two separate decontamination rooms for cleaning, sterilising and packing dental instruments. There is also a reception and a main waiting area on the ground floor with other seating areas available on the first floor.

One of the practice owners 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.

This was an unannounced inspection visit. We spoke with six patients during the inspection to obtain their views and details of their experience of the practice. These provided a generally positive view of the services the practice provides. All of the patients commented that the quality of care was good.

Our key findings were:

• Systems were in place for the recording and learning from significant events and accidents.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Patients were treated with dignity and respect.
• The practice was visibly clean and well maintained.
• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.
• Staff had been trained to deal with medical emergencies.
• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.
• Infection prevention and control systems were in place, and audits were completed on a six monthly basis.
• Options for treatment were identified and explored and patients said they were involved in making decisions about their treatment.
• Patients’ confidentiality was maintained.
• 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.
• Some staff from within the practice visited local schools to provide oral health and hygiene advice to children.

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

• Establish and operate effectively an accessible system for identifying, receiving, recording, handling and responding to both verbal and written complaints by service users.
• 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 demonstrate which staff have undertaken fire drills.

This dental practice location is a large dental practice, owned and operated by three people. It is situated on the main high street in Cradley Heath. The practice is made up of a large team which includes dentists, nurses, therapists, managers and receptionists.

The practice location also offers a domiciliary service to people living in care homes. We did not look at this part of the service during this review.

This practice provides a full range of general dental assessments and treatments and also offers a range of cosmetic services.

The practice location has a total of 19 treatment rooms. At least five of these are located on the ground floor. This means that the practice can offer treatment to people with mobility restrictions or who may use wheelchairs. One treatment room on the ground floor has a specialist chair. The arm can be moved which allows people to transfer from wheelchairs. Equipment in this room is portable so people can be examined and treated in their wheelchair if they wish.

People receiving care and treatment from this practice location pay independently or can access their dentistry through NHS costs. The practice has a current contract with the NHS to provide NHS dental care to people.

As part of our review we spoke with two people in the waiting room and four people by phone. The people we spoke with by phone had all recently received treatment from this dentist. People spoke highly of this dentist practice. People were satisfied with the care and treatment they had received. Below are a few comments people made;

“I do not know where the staff gets their training from; they are so good and so friendly as well.”

“The staff are lovely. They are polite and friendly. They really make you feel at ease”.

“I have been using this dentist for years. I have to travel a long way. It is worth it, I would not go anywhere else”.

“I always get an appointment to suit me”.

We looked at a website called ‘NHS choices’. This website allows people to make comments about the services they have received. We saw that there were many positive comments about this dentist practice. Some of these comments are shown below;

“Staff very pleasant, and put me at ease. They had time to discuss the options for my treatment. Appointments are on time”.

“I was treated very professionally and with sympathy for my nervousness throughout”.

Evidence that we gathered during this review confirmed that people are assessed to decide what dental and oral healthcare needs they may have. Treatments that people may need are discussed with them and are carried out in a satisfactory way.

Overall we found good practices regarding infection control and cleaning procedures which demonstrated compliance in this area. We made some suggestions for minor adjustments and additions to processes which could enhance these processes further. The provider and managers were receptive to our suggestions and confirmed that they would action these.