We carried out a comprehensive inspection of Collins House Dental Surgery on 14 January 2015.

The practice provides NHS dental treatment and private dental treatment. It is part of a national dental payment plan scheme and takes part in that organisation’s quality assurance arrangements.

The practice is situated in a converted former residential property in Hereford city centre. The practice has six dental treatment rooms and a decontamination room for cleaning, sterilising and packing of dental instruments. The main reception area and waiting room are on the ground floor and there are additional waiting areas near to the treatment rooms.

The practice has a full time practice manager. The principal dentist is registered with the Care Quality Commission as the registered manager. They are legally responsible for making sure the practice meets the regulations from the Health and Social Care Act 2008 relating to the quality and safety of care.

The practice has four dentists, two dental hygienists, a dental therapist and eight dental nurses. The practice manager and clinical team are supported by three receptionists.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to use to tell us about their experience of the practice. We collected seven completed cards. These provided a positive view of the service the practice provides. Patients told us that the care and treatment they received was caring, patient and thorough. They praised the skills of the clinical staff and the professionalism of the whole practice team.

The dental payment plan organisation which the practice was a member of carried out on-going surveys of patients’ views about the practice. We saw the results of surveys completed by 940 patients during 2014. These showed that 94% of patients rated the dental team as ideal, 96% felt that cleanliness and hygiene were excellent and 93% considered the team to be competent and explained treatments clearly.

Our key findings were:

• Staff reported incidents and kept records of these which the practice used for shared learning.
• The practice was visibly clean and well maintained.
• 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.
• The practice had effective safeguarding processes and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).
• The practice took into account any comments, concerns or complaints and used these to help them improve the practice.
• Patients were pleased with the care and treatment they received and complimentary about the dentists and all other members of the practice team.

As part of our review we spoke with five people who were at the practice for treatment when we visited and spoke with six others by phone. Some of these people also told us about the opinions of other people in their family and how their children were treated at the practice. We spoke with the senior partner in some detail and had conversations with the other three dentists, four of the nurses, two receptionists and the practice manager.

We were able to see other information about checks on the practice in the form of the most recent Denplan Excel report and an infection prevention and control report following an audit by the Lead Nurse for Infection Prevention and Control at NHS Herefordshire.

All of the information we obtained from our contact with people who attend Collins House was positive. People spoke highly of all of the staff and told us that they trust their dentist and feel safe. People used words like ‘brilliant’ and ‘amazing’ and told us stories of how the practice had helped them overcome their fear of dentists or supported them through extended periods of treatment. One person summarised the views of many when they told us “Overall I can only highly praise Mark and his team; the premises are lovely, the reception staff friendly …… and the care I receive is excellent.”

People felt involved in making decisions about the dental care they receive and were given the information they needed about this and the costs involved.

There were arrangements in place to deal with emergency situations including annual training for all staff in first aid, resuscitation and the use of a defibrillator.

Everyone working at the practice had an enhanced level criminal records bureau check. All of the dentists and nurses were qualified and registered with the General Dental Council and expected to work to their professional codes of practice. A trainee dental nurse was nearing the end of her training and due to take her final exams.

Safeguarding information was available and included the arrangements for child protection but this needed to be developed to include adult safeguarding. The senior partner acted on this immediately. We have been told that as a result of his discussions with local safeguarding managers, work is in now hand to make adult safeguarding and Mental Capacity Act information and training available to all dental professionals in the county.

We found that the arrangements for the management of the practice took account of national guidance about safety in important areas such as the control of infection and the decontamination of instruments, and the management of mercury. The practice had an open attitude to learning when a problem arises and we saw evidence of changes made in response to complaints and incidents.

We found that the practice had a welcoming atmosphere and this was reflected in what people we spoke with told us. The staff were open and had a positive and enthusiastic approach to their work and felt well supported by their employers.