We carried out an announced comprehensive inspection on 25 July 2016 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

Greatteeth White Friars Chester is located in the centre of Chester and comprises a reception area, two waiting rooms, two treatment rooms and an X-ray room on the ground floor, and two treatment rooms, two further waiting rooms, offices and storage rooms on the first floor. Parking is available on nearby streets and in car parks. The practice is accessible to patients with disabilities, impaired mobility but not to wheelchair users.

The practice provides general dental treatment and more complex treatments to patients of all ages on a privately funded basis. The practice is open Monday to Thursday 9.00am to 5.30pm and Friday 9.00am to 4.00pm. The practice is staffed by a principal dentist, a practice manager, who is also a dental nurse, a dental hygienist and four dental nurses, two of whom are also receptionists.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. 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 received feedback from eight people during the inspection about the services provided. Patients commented that they found the practice excellent and that staff were professional, friendly and caring. They said that they were always given good explanations about dental treatment. Patients commented that the practice was clean and comfortable.

Our key findings were:

• 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 and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• The premises and equipment were clean, secure and well maintained.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards and guidance.
• 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, and their confidentiality was maintained.
• 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 into account patient feedback.
• Staff were supervised, felt involved and worked as a team.
• Governance arrangements were in place for the smooth running of the practice and for the delivery of person centred care.
• Infection control procedures were in place however improvements were needed to the decontamination rooms and storage of some of the instruments. This was being addressed by the provider.

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

• Review the practice’s infection control procedures and protocols having due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance, specifically in relation to the decontamination rooms and the storage of instruments.

People told us that they were happy with the service provided. They felt their dignity was maintained and their privacy protected. They said they were encouraged to ask questions and felt staff had the time to answer their questions.

People told us that they felt they had enough time and information to make a decision about their treatment and that the dentist listened to them and talked through all the different treatment options. They also told us that they were provided with written information about their individual treatment options and costs before making a decision. One person said the dentist had “at every stage, fully and clearly informed me of all the procedures and this has been very reassuring”.

People told us that the clinic was comfortable and accommodating and that appointments were flexible to meet their needs.

Other comments about the service included: “Brilliant”; “My wife and I have been coming here for 10 years. They are very good, very friendly and very efficient”; “I have spent more time than most in a dentist’s chair over the years, but have never felt so assured and confident as I do with Dr Magee”.

People also told us that the surgeries were always clean when they visited.