We carried out an announced comprehensive inspection on 10 November 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

Bourne End Dental is a dental practice providing private treatment for both adults and children. The practice is based in a former domestic dwelling in Bourne End, a village situated in south Buckinghamshire.

The practice has seven dental treatment rooms; two of which are based on the ground floor and a separate decontamination room used for cleaning, sterilising and packing dental instruments. The ground floor is accessible to wheelchair users, prams and patients with limited mobility.

The practice employs six dentists, four visiting dental specialists, three hygienist, one dental therapist, 10 dental nurses, two reception staff, one assistant manager and a practice manager.

The practice’s opening hours are 8am to 5pm Monday to Thursday, 8am to 4pm Friday and 9am to 2pm Saturday.

There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an emergency service with each of the dentists taking it in turn to be on call. Their mobile number for on call is given and arrangements are made if the patient needs to be seen.

The provider, Mr. Stephen Rees, shares the practice facilities with another dentist who is separately registered with CQC. Facilities are shared and patients can register with either of the dentists. The dental nurses and support staff are employed jointly by both dentists.

Mr. Andrew Chandrapal is registered as an individual and is legally responsible for making sure that the practice meets the requirements relating to safety and quality of care, as specified in the regulations associated with the Health and Social Care Act 2008

We obtained the views of 15 patients on the day of our inspection.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by senior clinicians and an empowered practice manager.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
• Staff we spoke with felt well supported by the senior clinicians and practice manager and were committed to providing a quality service to their patients.
• Information from 96 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

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

• Consider providing the hygienist with the support of an appropriately trained member of the dental team.
• Consider the addition of General Dental Council (GDC) registration numbers of dentists working at the practice on the external name plate in accordance with GDC guidance issued in March 2012.
• Consider putting together a set of standing operating procedures for the dental laser in accordance with the Guidance for Employers on the Control of Artificial Optical Radiation at Work Regulations (AOR) 2010.

We spoke with four people who had received treatment on the day of our visit. All were satisfied with the treatment and care they had received. People said treatment options were explained and discussed with them and costs were known before treatment started. People said appointment times were flexible and emergency appointments were offered promptly. Staff were described as friendly and helpful. One patient said ''they're very good here.'' Another commented ''best dentist I've ever had.''

No one raised any concerns about their experiences of using the practice. Everyone we spoke with said there were good standards of hygiene. One person said ''they always wear gloves and offer goggles.''