We carried out this announced inspection on 8 October 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 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

Bupa - Binley Road is in Coventry and provides NHS and private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including one for blue badge holders, are available in the dedicated practice car park.

The dental team includes four dentists, four dental nurses, one dental hygienist, one receptionist and the practice manager. The practice has three treatment rooms.

The practice is owned by a corporate company 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 BUPA – Binley Road, Coventry is the practice manager.

On the day of inspection we collected six CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, one dental nurse, one receptionist, the practice manager, the clinical support lead, the area manager and the regional operations director. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday from 8am to 5.30pm

Tuesday from 8am to 6.30pm

Wednesday from 8am to 5pm

Thursday from 8am to 5pm

Friday from 8am to 4pm

Alternate Saturdays from 9am to 2pm

Our key findings were:

• The practice was part of a large corporate group which had a support centre based in Bristol where support teams including human resources, IT, finance, health and safety, learning and development, clinical support and patient liaison services were based. These teams supported and offered expert advice and updates to the practice when required.
• The practice appeared clean and well maintained. The practice used a contracted company to provide cleaning within the practice.
• The provider 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 to patients and staff. The practice had access to support from a dedicated health and safety team based within the company’s support centre.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures. The practice had access to support from a dedicated human resources and recruitment team based within the company’s support centre.
• The clinical staff provided patients’ care and treatment in line with current guidelines. New updates were shared with staff at practice meetings.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information. The practice had three waiting rooms which were set aside from the reception desk which enhanced patient confidentiality.
• The provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs. Patients could access routine treatment and urgent and emergency care when required.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team. There was an effective staffing structure which extended to senior management who were visible and supported the practice manager on the day of our visit by basing themselves at the practice.
• The practice asked staff and patients for feedback about the services they provided. Feedback from patients was displayed in the reception and on patient information folders in the waiting rooms.
• The provider dealt with complaints positively and efficiently. Learning was shared with staff and improvements were made as a result of complaints.
• The provider had suitable information governance arrangements.

There was an area where the provider could make improvements. They should:

• Review staff training to ensure that all of the staff had undergone relevant training in particular immediate life support for staff administering treatment for patients under sedation within the practice.

The practice employed two dentists and a dental hygienist. There were two treatment rooms that were used by the dentists, one on the ground floor and one on the first floor. The hygienist used a separate room on the ground floor.

We spoke with six people who used the service. People told us they were happy with the service they received. One person told us ”I couldn’t fault them. They are brilliant….a big tick from me.” Another person told us “Their care and attention is really good.”

We examined three patient records. We saw a health assessment and medical history had been completed for each patient that was updated during subsequent visits. This meant the dentist was alerted to any medical conditions that may affect a patient's treatment.

There were enough staff to meet people's needs. There were a total of three dental nurses, the practice manager, a hygienist and two dentists. In addition there were two receptionists who answered the telephone and greeted visitors.

The practice had procedures in place to monitor and improve the quality of the service provided. Evidence was available to show regular audits were taking place.