We carried out an announced comprehensive inspection on 19 January 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

Kingfisher Dental Practice is situated in a residential area of Redditch in a converted residential building. It provides NHS and private dental care. The practice has six dentists and seven dental nurses, five of whom also carry out reception duties. There is also a trainee dental nurse/receptionist and another receptionist. The practice has five dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments. The reception area and main waiting room are on the ground floor. There is a further waiting area on the first floor.

During 2015 the provider upgraded the practice. They converted two rooms on the first floor to provide two new treatment rooms and completely refurbished a ground floor treatment room.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to tell us about their experience of the practice. We collected 32 completed cards. All the patients we received feedback from were complimentary about the practice and the care and treatment they received. More than half wrote more detailed comments saying how highly they thought of the service they received. Patients commented on being treated with respect and kindness, being put at ease and finding their appointments a relaxed and pleasant experience. Some patients specifically mentioned how the practice had helped them overcome their anxiety about dental treatment and others described how caring the dentists were towards their children. Patients could access treatment and urgent and emergency care when required. A quarter specifically mentioned that the practice is safe, clean, and hygienic.

We saw the practice’s NHS Friends and Family results for April 2015 to January 2016. Out of a total of 88 responses 95% said they were ‘extremely likely’ or ‘likely’ to recommend the practice.

Our key findings were:

• Patients who completed CQC comment cards were all positive about the practice team and the care and treatment provided.

• The practice had a health and safety policy, relevant safety related risk assessments and an accident book. They did not have a policy or an established process for reporting and recording significant events.
• The practice was visibly clean and a number of patients commented on their satisfaction with hygiene and cleanliness.
• The practice had well organised systems to assess and manage infection prevention and control.
• The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• The practice had recruitment policies and procedures and used these to help them check the staff they employed were suitable. The practice obtained the correct information for new staff but their written policy and procedures did not fully reflect the requirements of legislation.
• Dental care records provided comprehensive information about patients’ care and treatment.
• Staff received training appropriate to their roles and were supported in their continued professional development.
• Patients were able to make routine and emergency appointments when needed.

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

• Establish a policy and processes for reporting and recording significant events to ensure that when incidents happen they are investigated, used to make improvements and recognised as opportunities for shared learning within the team.
• Provide signs on the doors of rooms where X-ray machines are located to identify the presence of radiography equipment.

• Review the practice’s recruitment policy to fully reflect the requirements of Regulation 19(3) and Schedule 3 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Have arrangements in place for the use of interpreters in situations where patients may not wish to have a relative involved or do not have a suitable person to assist them.

As part of this inspection we spoke with the practice manager, a dentist, a receptionist, and two dental nurses and on the telephone with nine people who used the practice.

People that used the practice were very complimentary about the care and treatment they and where applicable their family members received. People told us they were given enough information about their treatment options. One person we spoke with told us, “X explains everything to me”. Another person said, ”They talk you through everything”.

We found that the practice was clean and well organised and there were arrangements in place to ensure equipment was cleaned after use. Two people we spoke with described the cleanliness of the environment as, “Spotless”.

The dentists and staff that worked at the practice were suitably qualified and were supported by the provider to maintain their continuous professional development (CPD). In addition to this staff received training on safeguarding children from abuse and the action they should take if they suspected abuse and who to contact. We found that some improvements were needed to ensure staff had the appropriate information and contact numbers available to them to enable them to report suspected abuse of adults.

There were arrangements for monitoring the quality of the service. We saw that people were encouraged to provide feedback about the practice and we saw evidence that actions had been implemented from this.