We carried out an announced comprehensive inspection on 17 December 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.

Dr. Anthony Fagg provides NHS and private dental treatment. The majority of patients at the practice are private with approximately 35% NHS patients. The practice is situated in South Walls, Stafford, Staffordshire. Dr. Anthony Fagg is co-located with another individual dental provider who share the same premises and staff team. Dr. Anthony Fagg has been working at the practice for 30 years. The practice team includes four dental hygienists/ therapists, four dental nurses and two reception staff. The practice is supported by a practice manager/dental nurse. The practice relocated to its current location in 2010. The practice has been reconfigured to the providers’ specification and had been subject to recent refurbishment. The treatment room surgeries are fully equipped and the airy reception area enables patient privacy with distance between the reception desk and the waiting room area on the ground floor. The practice has a further waiting room area on the first floor and both reception and waiting room areas have CCTV monitoring which reception staff manage and was well advertised throughout the practice and within the practice literature. The main entrance to reception is accessible to patients with restricted mobility. The practice has three dental treatment rooms on the first floor accessible via stairs and one to the ground floor. The practice has a separate room which provides an area for the decontamination and cleaning, sterilising and packing of dental instruments.

Before the inspection we sent Care Quality Commission (CQC) comment cards to the practice for patients to use to tell us about their experience of the practice. We collected 48 completed cards. These provided extremely positive views of the service the practice provides. Patients told us the practice was excellent and that the dentist was professional, caring, understanding of their anxieties, thorough and helpful and went above and beyond their expectations. Several patients specifically commented that the dentist put them at ease and had allayed their fears. We spoke with four staff members all understood the needs of their patients living with dementia illnesses and those with learning disabilities. They understood their responsibilities under the Mental Capacity Act (2005).

Our key findings were:

• The practice had systems for dealing with significant events and accidents and staff understood their responsibilities for providing a safe service.
• The practice was visibly clean and had processes to help staff manage infection prevention and control effectively.
• The practice had systems, medicines and equipment for the management of medical emergencies and staff were trained to know how to deal with these.
• The practice had safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• Dental care records included the essential information expected about patients’ care and treatment including treatment plans and consent to care and treatment.
• The practice was committed to staff education and development. Staff received training appropriate to their roles and were encouraged and supported in their continued professional development (CPD).
• The practice received very few complaints but had a clear system for handling and responding to these.
• Patients who completed Care Quality Commission comment cards were pleased with the care and treatment they or their family member received and were complimentary about the whole practice team.
• The practice had well organised governance and leadership arrangements and an open door policy which made staff feel valued and listened to.
• The practice had open and supportive leadership and staff were happy in their roles, professional and enthusiastic.

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

• Consider adding further detail regarding the treatment provided to patients’ within the care records and consistently update the health promotion advice given to patients.

• Re-evaluate the process in place for dating the pouched instruments and put a protocol in place.

•  There should be a safer sharps policy available to all staff and ensure there is a risk assessment in place regarding the disposal of sharps systems the dentist utilised.

We carried out this inspection to check on the care and welfare of people using this service. We planned and discussed this inspection with the practice manager one day in advance. This was to ensure that we had time to see and speak with staff working at the practice, as well as people registered with the practice.

During the inspection we met the dentist, the practice manager and two dental nurses. We reviewed three dental records, two staff files, some of the practice’s policies and procedures and their quality audits.

During our inspection we spoke with three people who visited the practice and we telephoned three people at home who were registered with the practice. People that used the practice told us that they received planned care and treatment. People told us that they were very pleased with the service and had no cause to complain.

We saw that at each consultation people’s medical history was checked and signed by the person and the dental nurse told us oral care advice was given as part of the treatment. People we spoke with told us that the environment was always hygienic, clean and tidy.

We saw that the practice followed a recruitment procedure and we saw that the necessary checks were made prior to employment.

The practice manager monitored the service they delivered with a comprehensive auditing system. The practice regularly asked people for feedback to monitor the service they received and to ensure a high standard was maintained.