We carried out an announced comprehensive inspection on 30 January 2017 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

Bryn Street Dental Clinic is a dental practice providing NHS and private treatment for both adults and children; they are known locally as Boutique Dental 23. The practice is based in a mid terrace property in the village of Ashton-in-Makerfield.

There are six treatment rooms located over two floors, a dedicated decontamination room for sterilising dental instruments, a general office and a staff kitchen. Car parking is available on the side-streets near the practice. The practice was accessible to people with disabilities and impaired mobility.

The practice employs seven dentists, one of whom is a foundation dentist, one dental therapist, one hygienist and 12 dental nurses, three of whom are trainees. The clinical team is supported by a business manager, a practice manager and reception staff. Bryn Street Dental practice is a foundation training practice. Dental foundation training is a post-qualification training period, mainly in general dental practice, which UK graduates need to undertake in order to work in NHS practice.

The practice’s opening hours are 8am to 6pm from Monday to Wednesday, 8am to 7pm Thursday and 8am to 5pm Friday.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

We reviewed 48 CQC comment cards on the day of our visit; patients were extremely positive about the staff and the standard of care provided by the practice. Patients commented they felt involved in all aspects of their care and found the staff to be helpful, respectful, friendly and were treated in a clean and tidy environment.

Our key findings were:

• The premises were visibly clean and tidy.
• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• The practice was highly proactive in providing preventative care and advice in line with the ‘Delivering Better Oral Health’ toolkit (DBOH).
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Clinicians at the practice were members of Greater Manchester Local Dental Network and had contributed to the development of dental trauma pathways that were in use in the locality.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.

We identified the following notable practice:

• The practice was a pilot site for a number of patient pathways and initiatives promoting prevention and improved dental health, some of which became national guidance.

• We think this is notable practice because it demonstrates a commitment to improving oral health utilising the different skills within the practice and within the locality.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

Patients we spoke with were very happy with the treatment they had received. One patient told us they would recommend the surgery to anyone and another said it was “Marvellous.” Patients told us the staff were always very helpful. Patients were not fully aware of how to make a complaint but said they had never had any concerns or issues about the treatment received. They said the surgery was always clean.

Patients told us they were given medical questionnaires to complete and that their medical history was always checked prior to receiving any treatment. They told us their treatment options were always discussed and that they were given a written copy of their treatment plan along with an estimate of any cost involved.