We carried out an announced comprehensive inspection on 29 April 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.

Maple Dental Clinic is a general dental practice in central Luton, Bedfordshire offering NHS and private dental treatment to adults and children. The premises are located on the ground, first and second floor and consist of five dental treatment rooms, a reception area, two waiting areas and a designated decontamination room.

The staff at the practice consist of a practice manager, a principal dentist, four associate dentists, a visiting specialist in oral surgery, two dental nurses, six trainee dental nurses and four receptionists.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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.

The practice is a training practice for the Dental Foundation Training (DFT) scheme. DFT provides postgraduate dental education for newly qualified dentists in their first (foundation) year of practice; usually within general dental practices. The principal dentist is a trainer for the DFT scheme and provides clinical and educational supervision. The practice currently has one dentist who is in their first (foundation) year of practice.

Our key findings were:

• There was an induction programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and dentists took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• The practice placed an emphasis on the promotion of oral and general health and the prevention of dental disease. Appropriate information and advice was available according to patients’ individual needs.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received clear explanations about their proposed treatment, and its 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.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring and very welcoming.

• There was an effective system in place to act on feedback received from patients and staff.

• We reviewed 74 Care Quality Commission (CQC) comment cards that had been completed by patients in the two weeks prior to our inspection. Common themes were patients felt they received excellent care from dentists who were kind, caring and gentle. They also commented that dental nurses appeared well trained and the reception staff were always smiling, helpful and welcoming.

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

• Review audit protocols to ensure the practice audits its infection control procedures every six months in accordance with guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.

• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.

When we visited Maple Dental Clinic, we spoke with four people seeing a dentist that day. They told us how satisfied they were with the service. One said, ‘‘The dentist explains everything and is very good. He gave my teeth a thorough cleaning and explained dental hygiene. He gave me praise when I came back, having followed the good advice he gave me. Service is really good and the staff are very helpful. I have recommended them to several of my family.’’ Another said, ''It is good, I see the same dentist as I don't like seeing different people. The dentist explains things to me and doesn't suggest work unless it is necessary. Any fees are discussed in advance.''

The surgery had sufficient processes in place to ensure that treatment was delivered safely. All areas of the building were clean and tidy and there were robust infection control processes in place to ensure people were treated safely.

We saw that the practice regularly asked people what they thought of the service. Comments books and suggestion boxes were widely available throughout the clinic. Comments or complaints were dealt with appropriately to ensure people continued to receive a good service.

The clinic was able to offer a service by dentists and/or dental nurses in a number of different languages and this was publicised by notices in the reception and waiting rooms. Surgeries were accessible for people with limited mobility. The clinic respected people's diversity and cultural needs.