We carried out a comprehensive inspection of Hereford Dental Clinic on 6 January 2015.

Hereford Dental Clinic is a private dental practice which provides general dentistry and also specialises in providing complex treatment for patients with extensive tooth and gum problems and for nervous patients including those with significant anxieties about having dental treatment. The practice caters for children and adults and is close to Hereford city centre.

The practice is situated in a converted end terrace house. The practice has four dental treatment rooms and a decontamination room for cleaning, sterilising and packaging dental instruments. The reception area and waiting room are on the ground floor.

The practice has a full time practice manager who 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 seven dentists, a clinical dental technician and four dental nurses. A dental hygienist provides preventative advice and gum treatments on prescription from the dentists working in the practice. The practice also uses specialist input from a consultant anaesthetist, a clinical dental technician and a dental hypnotist. The practice manager and clinical team are supported by a patient co-ordinator and two 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 14 completed cards. These provided a positive view of the service the practice provides. We also spoke with five patients on the day of the inspection. Patients were complimentary about the friendliness and professionalism of staff, the care and treatment they received and the standards of cleanliness at the practice.

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.
• The practice specialised in supporting nervous patients to overcome their anxieties about having dental treatment. Patients were particularly appreciative of the care and understanding they were shown.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).
• The practice provided the option of sedation to patients and carried this out in line with guidelines from the Society for the Advancement of Anaesthesia in Dentistry (SAAD)
• The practice took into account any comments, concerns or complaints and used these to help them improve the practice.

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

• Develop a written sedation and discharge protocol.

• Develop the content of treatment plans for referrals to other members of the practice team and external dental professionals.

• Introduce a process for assuring themselves that these members of the team who are self employed have a good understanding of safeguarding arrangements.