We carried out an announced comprehensive inspection on 1 November 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

Holbrooks Dentalcare is a general dental practice situated in the Holbrooks area of Coventry, West Midlands. It provides dental treatment to adults and children funded predominantly by the NHS, but some patients are privately funded.

The practice offers general dental treatment and also treatment under conscious sedation (these are techniques in which the use of a medicine or medicines produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation).

The practice has six dental treatment rooms and a dedicated decontamination facility. These are all located on the ground floor and the service is completely accessible to patients who use a wheelchair, including the toilet.

The practice is open from 8.30 am to 5.30 pm Monday to Friday and Saturday 8.30 am to 12.30 pm.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We received feedback from 39 patients. These provided a very positive view of the services the practice provides. Patients commented on the quality of care, the polite and friendly nature of staff and the cleanliness of the practice.

Our key findings were:

• The practice was visibly clean and clutter free.

• The practice was taking on NHS patients at the time of the inspection and patients could expect to be offered an appointment within a few days.

• Comments from patients indicated that staff were friendly and helpful and clinicians took the time to explain treatment options.

• Staff used nationally recognised guidance in the care and treatment of patients.

• The practice met the national guidance in infection control measures with the exception of checking the ultrasonic bath solution temperature, which was rectified immediately following the inspection.

• Pre-employment checks did not always contain all the recommended information, although this was provided following the inspection.

• Emergency medicines were in place to treat medical emergencies in line with national guidance.

• The practice offered conscious sedation and met national standards in the provision of this treatment.

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

• 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.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.

During our visit on 21 March we spoke with the provider, lead dentist, practice manager, and one of the dental nurses. We spoke with six people who attend Holbrooks Dentalcare. They all gave positive feedback about the service they had received. They told us, “It’s an excellent dentist, everyone is really friendly” and “The dentist I see makes you feel at ease, she explained everything to me so I understood what she was going to do.”

People told us that they are able to make an appointment quiet easily and do not have to wait very long to see the dentist when they arrive. One person said “I don’t have to wait long at all, probably five minutes at the most.”

We asked the dentist how the surgery decides on a treatment plan with a person. We were told this would depend on the oral health assessment that is completed at the start of each course of treatment. We were shown a completed assessment and people we spoke with told us that everything was always explained to them. One person told us “The treatment options were fully explained to me. I was shown the x rays and what needed to be done”.

People we spoke with said that everything in the practice always looked clean and tidy. People confirmed that the dentists and nurses offered them glasses to protect their eyes during treatment. We were told the dentists wore these themselves and that they always wore disposable gloves. We observed the process for cleaning instruments and the nurse described how the equipment was monitored to ensure it was working efficiently. Staff spoken with told us that they had attended training in the decontamination of equipment. Staff said they felt confident with this procedure.

Staff spoken with told us that they were very happy working at the practice and that they received a good level of support from the dentists and practice manager

We asked if people had ever made a complaint. People we spoke with said that they had never had any reason to complain. But they would speak to the dentist if they were unhappy with anything.

All the people we spoke with were happy with the service they received. One person said “I am more than happy with the service they provide” and another said “All the staff are friendly, the dentists are extremely professional and the treatment has been first class.”