We carried out an announced comprehensive inspection on 29 November 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Priory Dental Practice is situated in the centre of the city with easy bus access. This well established practice has recently undergone extensive refurbishment providing a safe and ‘fit for purpose’ environment for the treatment of patients in line with current best practice. The practice provides both private and NHS general dental services to children and adults and also provides in house oral surgery services for those patients who require such treatment.

Fees are displayed in information leaflets available in the practice for patients and on the website. The practice is located on ground floor with access to all facilities for patients with mobility difficulties, and has two treatment rooms, one waiting room and a decontamination room. The practice has a team of two dentists and four dental nurses, a practice manager and receptionist.

The principal dentist is the registered provider. 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 is open Monday and Wednesday - 9.00am to 1.00pm and 2.00pm – 5.00pm,Tuesday – 9.00am – 4.00pm, Thursday - 9.00am to 1.00pm and 2.00pm – 7.00pm and Friday – 9.00am to 4.00pm. The practice is closed alternate Saturdays and every Sunday but the out of hours emergency arrangements are displayed on their website. Contact information is available from the practice telephone answering service.

We reviewed 25 CQC comment cards that had been left for patients to complete prior to our visit. In addition we spoke with three patients on the day of our inspection. Feedback from patients was positive about the care they received from the practice. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Patients we spoke with and the comment cards told us staff were kind, caring, competent and put patients at their ease , A care home manager providing services for people with a learning disability commented that residents who came to the practice for treatment, always received empathic care and their dignity was respected.

Our key findings were:

• There were systems in place to help ensure the safety of staff and patients. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control and responding to medical emergencies.
• The dental practice had effective clinical governance and risk management processes in place; including health and safety and the management of medical emergencies.
• Patient care and treatment was delivered in line with evidence-based guidelines, best practice and current legislation. Patient dental records were electronic, detailed and comprehensive.
• The practice had a comprehensive system to monitor and continually improve the quality of the service; including through a detailed programme of clinical and non-clinical audits.
• Digital radiographs were used to help explain necessary treatment to patients while in the chair.
• Premises appeared well maintained and visibly clean. Good cleaning and infection control systems were in place. The treatment rooms were well organised 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.
• There were sufficient numbers of suitably qualified staff who maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines, supported in their professional development and the practice was led by a proactive new principal dentist.

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

• Review the records retention policy so that clinical dental record retention aligns with the current NHS Code of Practice for Records Management (2016).
• Review the type of clinical waste bins in the decontamination room which were not all foot operated.
• Review the arrangements for access and security of the decontamination room as this was not locked and contained sharps and instruments as well as emergency medicines.