We carried out this announced inspection of Brunswick Dental Practice 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. A CQC inspector, who was supported by a specialist dental adviser, led the inspection.

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 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 well-led care in accordance with the relevant regulations.

Background

Brunswick Dental Practice is a well-established practice based in Norwich City Centre that provides both NHS and private treatment to patients of all ages. The dental team consists of a dentist, a dental therapist, three nurses and a practice manager. They provide dental services to about 4500 patients.

The practice has three treatment rooms and is open Mondays to Fridays from 7.45am to 5pm.

There is level entry access and a downstairs toilet for people who use wheelchairs.

The practice is owned by Dr Amanda Ricketts who is the principal dentist there. She has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of our inspection we collected 58 comment cards filled in by patients and spoke with another four.

During the inspection we spoke with the owner, the practice manager and a dental nurse. We looked at the practice’s policies and procedures, and other records about how the service was managed.

Our key findings were:

• The practice had systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• Risk assessment was robust and action was taken to protect both staff and patients.

• Staff had a good understanding of their differing patient population groups and had adjusted their services to meet their specific needs.

• Patients received their care and treatment from well-supported staff, who told us they enjoyed their work.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance. Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• There was a clear leadership structure and staff felt supported and valued by the principal dentist and practice manager. Teamwork in the practice was excellent and we were impressed by staff’s knowledge, enthusiasm and commitment to improve things where possible.
• The practice proactively sought feedback from staff and patients, which it acted on.

We spoke to five people while they waited to see the dentist. Each person spoke positively about the practice, describing the staff as "Lovely" and "Very helpful and pleasant." Two people told us that their children also received dental health care from this practice and that they were happy with the standard of care given to the whole family. Two people had recommended the practice to friends.

People told us that they felt safe in the surgery and were confident that they could raise any concerns with the staff. They told us that they were always given detailed explanations of their treatment plans and the fees for treatment. They also said that they were able to discuss the plans with the dentist: as one person told us, "I can always make my feelings known." This showed that people expressed their views and were involved in making decisions about their care and treatment.

The practice provided information in a welcome pack and on its website about fees, appointments, treatments offered and the complaints policy, as well as the practice's "patient's charter." We saw treatment plans and records which were completed and signed by staff and patients.

People were offered treatment in a clean and hygienic environment. The practice had recently been re-decorated. There was a separate decontamination room for the cleaning and sterilisation of dental instruments and waste material was stored and disposed of in a safe manner.