In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still the registered manager on our register at the time.

When we visited the practice on 26 June 2013 we found the provider did not have systems in place to ensure that the appropriate standards of cleanliness and hygiene were maintained in relation to premises, equipment and reusable medical devices and materials. The process for sterilisation of instruments using autoclaves was not fully in line with the best practice requirements of current national guidelines as there was no separate decontamination room. We asked the provider to make improvements.

We went back on this visit to see whether improvements had been made.

During our visit, we spoke with the area manager and a dental nurse. We found the previous registered manager at the practice had left on 20 December 2013. The area manager and a dental nurse explained the practice’s systems and processes to us.

The area manager explained that the practice currently employed seven dentists, a hygienist, seven dental nurses, three receptionists and a cleaner. They told us a new manager was due to start on the Monday following our visit, 6 January 2014, and would be applying to become the registered manager for the service. A new support manager, with a clinical background, and a trainee dental nurse were also due to start work at the practice on 6 January 2014.

We looked around the practice, including two treatment rooms and the decontamination room; all of these areas in the practice looked clean. We saw that, since our last inspection visit, all of the treatment rooms and public areas had been refurbished and redecorated. Flooring had been replaced in the public areas and the waiting areas also had new flooring and chairs. We saw that the practice now had a separate decontamination room for the sterilisation of dental instruments.

During our visit, we spoke with the practice manager, the assistant manager, a dental nurse and two patients who used the service. At the time of our visit the practice manager was new in post, so the assistant manager explained the practice’s systems and processes to us.

The practice employed six self-employed dentists, a hygienist and 18 dental nurses/receptionists. The assistant manager told us approximately 40,000 patients were registered at the practice.

The two patients we spoke with told us:-

“The staff are welcoming and friendly and the dentist gives you plenty of advice.”

“Everything’s fine. I’ve been going there all my life and can’t think of anything that could be improved.”

In the patient records examined we saw dentists discussed treatment options and any associated costs with patients. Patients told us any treatments, along with risks, benefits and options, were always explained fully by the dentists. Patients gave consent before receiving any treatment.

All of the clinical areas of the practice looked clean. This was confirmed by the patients we spoke with. One of them said “It always looks clean to me.”

However some of the treatment rooms and public areas were not all well-maintained. The practice manager told us they planned to refurbish the treatment rooms, hallways and corridors and replace the flooring and chairs in the waiting areas in the near future.

We saw that the practice did not have a separate decontamination room and instruments were being sterilised in the treatment rooms. When we asked the manager about this they told us the staff room was due to be converted to a decontamination room for the practice. This work was due to start in August 2013 and would take approximately six weeks.

Staff we spoke with told us they were confident the service provided was good. They said they received training appropriate to their role and felt well-supported by their managers.

We spoke with two people who use the service and they told us they were very happy with the service they received. The people we spoke with told us the staff are very friendly and are clear in explaining the treatment options that are available. They also told us that the clinic is very clean and tidy.