We carried out an announced comprehensive inspection on 13 July 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.

West End Apex Dental Centre is situated in the centre of Bradford and provides a range of dental services to NHS and private fee paying adults and children.

The practice has five surgeries, a decontamination room, an X-ray suite, a storage room, a large waiting area, reception area, toilets, the practice manager’s office and a staff room. The reception area is on the ground floor of the building. All the other areas are situated on the first floor of the building.

There are four dentists, one hygienist, six dental nurses, three reception staff, a practice manager and two practice support manager.

The opening hours are Monday to Thursday 8-30am to 5-30pm and Friday 8-30am to 5-00pm.

The practice manager is currently registering to be 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.

During the inspection we spoke with three patients who used the service and reviewed 32 completed CQC comment cards. Patients we spoke with and those who completed comment cards were generally positive about the care they received about the service.

They commented that staff were caring, helpful and respectful, treatment was well explained and the practice was clean and hygienic.

Our key findings were:

• The practice had systems in place to assess and manage risks to patients and staff including infection prevention and control, health and safety and the management of medical emergencies.
• Dental care records were detailed and showed that treatment was planned in line with current best practice guidelines.
• Oral health advice and treatment were provided in-line with the ‘Delivering Better Oral Health’ toolkit’ (DBOH).
• Patients were treated with care, respect and dignity.
• There were clearly defined leadership roles within the practice and staff told us that they felt supported, appreciated and comfortable to raise concerns or make suggestions.
• Staff received training appropriate to their roles.

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

• Ensure that rubber dam is used for all root canal treatments.
• Ensure that regular checks are completed to ensure that local anaesthetics are not out of date.
• Ensure that all single use materials are disposed of correctly.
• Ensure that a risk assessment is done on the floor in surgery 5 and suitable actions made to prevent accidents and allow thorough cleaning.

During the inspection we spoke with four people who used the service. They told us they were happy with the services they received. One person said “Everything is all right, I am happy”. Another person told us they had recommended the practice to their family, friends and work colleagues. Another person told us the practice had been recommended to them and they had not been disappointed.

People told us they were always given information about their treatment options. They all said the dentists were very good at explaining things. People said the staff were “friendly” and they said the surgery was always clean. The people we spoke with were not aware of the complaints procedure. However, they all said they never had any reason to complain and they felt confident any concerns they might have would be dealt with.

We found the provider had appropriate systems in place to ensure consent was gained before they carried out an examination or treatment.

We found the provider had taken steps which ensured the care and welfare of people who used the service. There were arrangements in place to deal with medical emergencies.

We found the environment was clean and tidy and there were suitable infection prevention and control protocols in place.

We found the provider had appropriate arrangements in place to ensure staff received suitable training.

We saw evidence there was an appropriate system in place for listening to and acting on people's comments and concerns.