We carried out an announced comprehensive inspection on 30 September 2015 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

The practice is situated in the village of Malpas, Cheshire. The practice has four dentists, a practice manager who is a qualified dental nurse and four trainee dental nurses. The practice provides primary dental services to predominately NHS patients. The practice is open Monday to Friday 8.30am – 5pm. Out of hours patients are directed to the emergency out of hour’s dental service with contact details displayed on the door and by telephone message.

The principal dentist is the registered provider. A registered provider is registered with the Care Quality Commission to manage the service. Registered providers 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 viewed 42 CQC comment cards that had been left for patients to complete prior to our visit and spoke to two patients on the day of inspection, about the services provided. All of the comment cards seen and patients spoken to reflected positive comments about the staff and the services provided. Patients commented that the practice appeared clean; they found the staff very caring, professional and friendly. They had trust and confidence in the dental treatments and said explanations were clear and understandable. Emergency appointments were available and appointments usually ran on time.

Our key findings were:

• The practice recorded and analysed incidents and complaints and cascaded learning to staff when they occurred.
• Staff had received safeguarding training, demonstrated good awareness and knowledge and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and emergency equipment were available.
• Infection control procedures were in place.
• Patients ‘care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.
• The practice staff felt involved and worked as a team.

• The practice sought feedback from staff and patients about the services they provided.

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

• Carry out and document staff appraisals to assess performance and develop training plans.
• Carry out regular clinical audits including radiographs and infection control audits and share resulting changes to practice with all staff.
• Ensure fire fighting equipment is serviced and maintained and staff have regular fire safety training in line with fire safety legislation.

We spoke to three people who used the service who told us they were given appropriate information and support regarding their treatment options and costs. They were very positive about the care and treatment they received.

The people we spoke to told us that consultations and treatments were undertaken in private, appointment times were flexible and that the surgery was accessible, comfortable and clean. Some comments made were; -

“I find the service absolutely brilliant. I can always get an appointment when I need one.”

“The service is very good. Appointments can be arranged very quickly. The treatments are clearly explained and advice is given when it's needed.”

“I have been coming here for a number of years. All the staff are very friendly. The service is very good.”

Surveys to find out people’s views were undertaken by the service. We looked at fifteen of the completed surveys. We found that people were overall happy about the service being provided. All considered that staff were friendly and that procedures and costs were explained. Two people had found the staff “fairly” helpful and one person felt that there should be additional opening times.

We asked the Cheshire, Warrington and Wirral Primary Care Team for information about how this service was operating. No issues of concern were reported.