We carried out an announced comprehensive inspection on 19 January 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

Hockley Heath Dental Care is a dental practice providing general dental services on a NHS and private basis. The service is provided by seven dentists, four of which attend on a regular basis. The other three dentists (the providers) attend on an occasional basis to provide dental implants and emergency cover when required. They are supported by three dental nurses (one of whom is the practice manager), an area manager (who is the registered manager) and a hygienist. All of the dental nurses also carry out reception duties.

The practice is located on a main road near local amenities and bus routes. There is wheelchair access to the practice and car parking facilities. The premises consist of a waiting room, a reception area, an office and two treatment rooms on the ground floor. One of the treatment rooms contains a dedicated area for decontamination procedures. The first floor is for staff use only and comprises of a kitchen, an office, a meeting room and toilet facilities for staff. There are toilet facilities for patients on the ground floor but these are not wheelchair-accessible. The practice opened from 8:30am to 5:30pm on Monday to Thursday and from 8:30am to 3:30pm on Fridays.

The area manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

Fourteen patients provided feedback about the practice. We looked at CQC comment cards patients had completed prior to the inspection and spoke with three patients during our visit. Patient feedback was overwhelmingly positive about the care they received from the practice. They described staff as caring, efficient and professional. Patients commented they felt involved in their treatment and it was fully explained to them. Nervous patients said they felt at ease here and the staff were sensitive to their needs.

Our key findings were:

• The practice was organised and appeared clean and tidy on the day of our visit. Many patients also commented that this was their experience.
• Patients told us they found the staff caring and courteous. Patients were able to make routine and emergency appointments when needed.
• An infection prevention and control policy was in place. We saw the decontamination procedures followed recommended guidance. We identified some necessary improvements and the registered manager responded promptly to action these.
• The practice had systems to assess and manage risks to patients, including health and safety, safeguarding, safe staff recruitment and the management of medical emergencies. We identified some necessary improvements which were promptly actioned.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Staff received training appropriate to their roles.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• Practice meetings were used for shared learning.
• The practice demonstrated that they regularly undertook audits in infection control, radiography and dental care record keeping. Some necessary improvements were required and these were implemented promptly.

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

• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development.
• Review the practice’s infection control procedures and protocols giving 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. This includes following guidance surrounding audits, storage of sterilised instruments and ventilation arrangements in the decontamination area.
• Review the protocols for completing accurate, complete and detailed records relating to the recruitment of staff. This includes ensuring recruitment checks, including proof of identification and immunisation, are suitably obtained and recorded.

We visited Hockley Heath Dental Care on 13 June 2013 . The practice had been taken over by the provider approximately twelve months previously. During our visit we spoke with a dentist, a dental nurse, the practice manager who was also the head nurse and the cluster manager for the group of dentists owned by the provider. Following our visit we spoke with six people over the telephone so we could gain people's views of the service provided.

People told us,

"I think they are absolutely marvellous. I have recommended them to so many people."

"It's good they do NHS work."

"I had to have a veneer and the dentist went through the whole procedure and what was the best option to go for."

"I thought they (the staff) were lovely. I couldn't compliment them enough."

People told us they were able to make an appointment quite easily. People said that when the provider first took over the practice they were often kept waiting to see the dentist when they arrived for their appointments. It had now improved. "Initially they were finding it difficult but nowadays it is extremely good."

During our visit we saw the practice was clean and tidy. Processes were in place to ensure that equipment was safe to use and high levels of cleanliness maintained.

The practice had systems in place to assess and monitor the quality of service provided.