We carried out an announced comprehensive inspection on 3 May 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

Mercian House dental practice is in Stourport on Severn town centre. The practice has two separate registrations with CQC. This is because the NHS treatment is provided by Jugminder Sanghera & Tina Devi Sanghera, a partnership, while private treatment is provided by J and T Sanghera Limited, a company. Because of this we produce two inspection reports. This report is about the service provided by the limited company to provide private care for children and adults. One of the directors is the principal dentist and registered manager, 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 has one dentist (the registered manager), a dental therapist, two dental hygienists, three dental nurses and a trainee dental nurse. The clinical team are supported by two reception staff. The dentist takes the lead role in the day to day organisation of the practice.

The practice has three dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments. There is level access from the pavement into the practice entrance hall, reception and waiting area. The patient toilet is on the ground floor. There are three steps to two treatment rooms and the staff areas; the other treatment room is on the ground floor.

The practice is open from 8.30am to 6pm on Tuesdays, 9am to 6pm on Mondays, Wednesdays and Thursdays and 8.30am to 5pm on Fridays.

The services provided included the option of treatment under conscious sedation and the practice made the expected arrangements to do this safely. Conscious sedation involves the use of medicines to reduce alertness and help the patient relax but still be able to hear and respond to the dentist if necessary while treatment is carried out.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to use to tell us about their experience of the practice. We collected 26 completed cards and also saw the practice’s NHS Friends and Family survey results for 2015. All the information showed that patients had a consistently positive view of the service the practice provides. Patients described the practice team as professional, friendly, caring and polite. They said they received calm, gentle treatment and careful explanations of the treatment they needed in language they could understand. The Friends and Family results collated in April 2015 showed that patients were likely, or extremely likely, to recommend the service. The November 2015 results all showed that patients were extremely likely to recommend the service.

Our key findings were:

• The practice was visibly clean and a number of patients mentioned that the practice was always clean and hygienic. The practice had 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 clear processes for dealing with medical emergencies and for ensuring that dental equipment was available and regularly maintained.

• Dental care records provided clear and detailed 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.

• The practice had established a variety of ways to gather patients’ views including in-house surveys and the NHS Friends and Family test.
• Patients received a responsive service and staff treated them in a thoughtful, respectful and professional way.
• The practice had governance processes to manage the practice effectively.

• We identified the practice had established a patient participation group. Members were invited to come to the practice each year. The practice used the meetings as another way to obtain patients’ views and written minutes were made and shared in the practice newsletter. This showed a positive and open approach to listening to patients. We believe this to be notable practice and is worth sharing.

During this inspection we spoke with a dentist who was also the registered manager. We spoke with two dental nurses that worked at the practice. We spoke on the telephone with five people who used the practice.

People felt they were given enough information about their treatment options and the relevant fees. People felt involved in the choice of treatments they required. One person said: “They always ask me what I want and they let me make a choice about which treatment I have”.

People that used the practice told us they were very happy with the quality of the information, care and treatment they received. One person we spoke with said: “Yes, definitely 100% satisfied”. Another person we spoke with said: “I was thinking of leaving them a while ago, I am so glad I decided to stay. I made the right decision”.

We found the practice was clean and hygienic. People we spoke with confirmed that this was their experience too. There were suitable arrangements in place for the cleaning, sterilising and storing of instruments so that people were not placed at risk of infection.

We looked at the recruitment process in place. We found that appropriate checks had been carried out before staff commenced employment.

The provider had systems of audits in place to enable them to monitor the quality of their service. This made sure that people received appropriate care and treatment.