We carried out this announced inspection on 9 April 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Brockley House Dental Practice is in Stroud and provides NHS and private treatment to patients of all ages.

There is a small step from the street into the practice and a ramp available to enable level access for people who use wheelchairs and those with pushchairs. Car parking is available in the roads or public car park near the practice.

The dental team includes seven dentists, one dental therapist/hygienist, three dental nurses, five trainee dental nurses and three receptionists. The practice has five treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Brockley House Dental Practice was the principal dentist.

On the day of inspection we collected 11 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists, two dental nurses, one receptionist and the principal dentist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Friday 9.00am – 1.00pm & 2.00pm – 5.30pm.
• Saturdays 08.30am – 1.00pm.
• Closed Sundays.
• Out of Hours information for NHS patients was displayed on website. There was no out of hour’s information for private patients on the website. The telephone answering service had these details.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had satisfactory staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• Staff felt involved, supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to agency and new staff commence employment at the practice.
• Review the practice waste handling protocols to ensure waste is segregated and disposed of in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01. For example in relation to amalgam which was observed in base of spittoons.

People made positive comments about staff and indicated that they felt safe and had confidence in the dentists and other staff who attended to them.

People commented that treatment options and fees had been explained to them in a way that they understood. People who used the service said that they felt involved in their treatment and that this was explained to them in detail.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People said they felt able to ask questions about their treatment to ensure they knew what to expect. They said the surgery was "clean and tidy" and that they had no concerns about the cleanliness at the surgery.

People can be assured that the services provided are monitored for quality as the provider had effective systems in place.