We carried out an announced comprehensive inspection on 30 June 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.

Parrys Lane Dental Practice provides private general and cosmetic dentistry to people living in the Stoke Bishop area of Bristol. The practice has five dentists, an oral surgeon, a specialist endodontist, a specialist orthodontist, a specialist periodontist and a dentist who specialised in dental implants. The majority of the patients at the practice pay for their treatment and there is a range of systems available, such as Denplan, for patients to access.

There is a registered manager in place, 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.

We reviewed 16 comment cards that had been completed by patients and spoke with two patients. The comments made praised the treatment provided and the staff team .Patients said they received professional, caring and compassionate care in a very friendly and clean environment. They used comments such as ‘first class service’ and ‘excellent’ to describe their experience of the practice.

Our key findings were:

• There were effective systems in place to reduce the risk and spread of infection.
• We found all treatment rooms well planned and equipped, with good light and ventilation.
• There were systems in place to check all equipment had been serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice kept up to date with current guidelines and was led by a proactive and forward thinking management team.
• During our visit we observed staff were kind, caring, competent and put patients at their ease.

We found two areas for improvement and these were allied to recruitment records and medicines storage and records of antibiotics and medicine used for conscious sedation. The provider and practice manager began to address these issues as they were raised during the inspection and confirmed to us that antibiotics were no longer dispensed by the practice.

In addition the provider should:

• Review its recruitment policy and procedures to ensure the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
• Review the practice’s protocols for conscious sedation, giving due regard to guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.

You can see full details of the regulations not being met at the end of this report.

On the day of our inspection we spoke with five patients, all of whom had been long term patients of the practice. We received a number of positive comments, including the "practice is accessible and accommodating", and "you're always made to feel welcome". Another person told us that they received "excellent treatment".

People told us that they were able to make emergency appointments if they required them. One person that we spoke with on the day of our visit was attending for an urgent concern. We saw that staff had been trained to respond to medical emergencies and there was emergency medication available should it be required. Staff were also aware of their responsibility to safeguard children and vulnerable adults.

Arrangements in place for the decontamination and sterilisation of dental instruments met with the requirements of the Health Technical Memorandum 01-05 (HTM). This is the guidance that all dentists are required to follow to ensure that their practice is safe and minimises the risk of cross infection.