We carried out an announced comprehensive inspection on 23rd February 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

Clarence House Dental Health Centre is located in the centre of Gloucester and provides private treatment to adults and NHS treatment to children. The practice consists of four treatment rooms, toilet facilities for patients and staff, a reception area, waiting areas, a consulting room, a staff room and an office.

The practice offers routine examinations and treatment. There are two dentists, two dental therapists/hygienists, one hygienist, eight dental nurses, two receptionists and a practice manager.

The practice’s opening hours are

8.00 to 19.00 on Monday

8.00 to 17.00 on Tuesday

8.00 to 17.00 on Wednesday

8.00 to 19.00 on Thursday

8.00 to 15.45 on Friday

They also open on the first Saturday in the month for half a day.

The practice is part of an independent group of dentists who run an on-call rota. Out of hours patients were directed to phone the dentist on-call.

We carried out an announced, comprehensive inspection on 23rd February 2017. The inspection was led by a CQC inspector who was accompanied by a specialist dental advisor.

For this inspection 49 people provided feedback to us about the service. Patients were positive about the care they received from the practice. They were complimentary about the service offered’ which they said was very good and excellent. They told us that staff were professional, welcoming, helpful, caring and friendly and the practice was clean and hygienic.

Our key findings were:

• Safe systems and processes were in place, including a lead for safeguarding but there was no lead for infection control.

• Staff recruitment policies were appropriate and most of the relevant checks were completed. Staff received relevant training.

• The practice had ensured that risk assessments were in place.

• The clinical equipment in the practice was appropriately maintained. The practice appeared visibly clean throughout although some surgeries and the decontamination room were cluttered.

•The process for decontamination of instruments followed relevant guidance.

• The practice maintained appropriate dental care records and patients’ clinical details were updated.

• Patients were provided with health promotion advice to promote good oral care.

• Consent was obtained for dental treatment.

• The dentists were aware of the process to follow when a person lacked capacity to give consent to treatment.

• All feedback that we received from patients was positive; they reported that it was a professional, caring and friendly service.

• There were arrangements for governance at the practice such as systems for auditing patient records and radiographs.

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

• Review the procedures for reporting accidents to include written information for staff about the process for reporting accidents and incidents.

• Review the system of team meetings to make sure practice based subjects such as health and safety, learning from accidents and incidents and learning from complaints are included as a regular agenda item.

• Develop policies and procedures about the duty of candour, to support a culture of openness and transparency.

• Review the recruitment procedures to ensure that written references are obtained before new staff start work in the practice in line with current guidance.

• Review the arrangements for support to staff to make sure all staff receive regular appraisals and personal development plans at least once a year.

• Review the arrangements for storing items in the surgeries and the decontamination room to make surfaces easier to clean.

• Review the arrangements for communication to include a hearing loop for patients with a hearing impairment and access to a translation service for people whose first language is not English.

• Review the arrangements for infection control to make sure a member of staff takes lead responsibility for infection control.