We carried out an announced comprehensive inspection on 7 June 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

Blue Cross Dental Care (Bilston) is a dental practice providing general dental services on a NHS (predominantly) basis. Some private treatment is also offered. The service is provided by four dentists. They are supported by five dental nurses (two of whom are trainees), a practice manager and a receptionist. All of the dental nurses also carry out reception duties.

The practice is located in a busy shopping area in the town centre. There is wheelchair access to the practice and nearby car parking facilities. The premises consist of a waiting room, three treatment rooms and accessible toilet facilities on the ground floor. The first floor comprises of a decontamination room, a staff room/kitchen, an office, a stock room, a storage room and toilet facilities. One of the treatment rooms was not used. Opening hours are from 7:30am to 5:30pm on Mondays, 8am to 5pm on Tuesdays and Wednesdays, 8am to 8pm on Thursdays and 8am to 6:30pm on Fridays. The practice is also open on Saturdays between 9am and 3pm.

The provider is registered with the Care Quality Commission (CQC) as an individual. 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. The provider does not carry out dental treatment at this practice.

Eleven patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with three patients. Overall the information from patients was complimentary. Patients were positive about their experience and they commented that staff were friendly and polite.

Our key findings were:

• The practice appeared clean and tidy on the day of our visit. Many patients also commented that this was their experience.
• Patients told us they found the staff polite and friendly. Patients were able to make routine and emergency appointments when needed.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. However, some improvements were required.
• 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.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping.

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

• Review the practice’s arrangements for dealing with medical emergencies during domiciliary visits.
• Review the practice's recruitment procedures to ensure they are in line with Schedule 3 of the Health and Social Care Act 2008 Regulations 2014.
• Review the practice’s infection control procedures regarding the testing of autoclaves giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• Review staff awareness of the duty of candour and RIDDOR regulations.
• Complete all recommendations provided on the practice’s fire risk assessment.

People we spoke with talked highly of the dental practice and shared positive experiences about their care and treatment. They told us they were made welcome and treated with respect. Comments included, “I’d definitely come back here again. They put me at ease and fully explained everything to me including the costs” and, “They were quick to see me and they treated me really well”.

People told us their treatment options were fully discussed with them which enabled them to make an informed decision about their treatment and their dental health needs.

People said they found the practice clean and hygienic. We saw the practice had effective arrangements in place for the safe management of infection control. Staff had received training to reduce the risk of cross infection.

People considered the staff were competent and knowledgeable. They said they found the staff welcoming and friendly. Staff told us they were provided with, “Very good” training opportunities to further develop their skills and knowledge in their work.

People had access to information about how to complain. They told us they had not had cause to complain but were confident any concerns raised would be listened to and addressed.