We spoke with four young people who used the service. They were complimentary about the staff and the service they received. We were told by those who were nearing the end of their treatment that they could see improvements. The provider received favourable comments from parents about their child's teeth and how this had improved their confidence.

The practice was suitable for people who used wheelchairs and information was available about the treatments offered. People were consulted and gave consent to treatment. Arrangements were in place to respond to any concerns about the safety of people who used the service. Staff were trained to deal with medical emergencies and there were medicines available for this.

The premises and equipment were well maintained and there were good arrangements for maintaining a clean and hygienic environment and for the decontamination of dental instruments.

Staff were recruited in a safe way and there were sufficient numbers of staff who felt supported and had opportunities for training.

The provider had an effective system to monitor the quality of the service including seeking people's views and responding to complaints.

We spoke with eight people who used the service and the responsible adults who were accompanying them, when we visited the practice on 28 February 2012. They told us the practice was always clean and comfortable and appointment times are flexible. Five of the people spoke to us before their treatment and told us the practitioner explained what was going to be done for to them in advance so they knew what to expect. They told us their treatment was always provided by the same practitioner unless it was an emergency. Young people under 16 who were attending unaccompanied told us they felt safe to attend on their own.

People told us they were happy with the service they received with one person stating “I am really happy here”. Another person told us “they provided me with a special gum shield so I could continue my sport”.

The surgery is open plan with small dividing panels between each area of treatment. People who spoke with told us they did not feel their privacy and dignity was compromised in any way. Practitioners who spoke with told us the open plan surgery is helpful to enable staff in training to be supported and observed, with least disruption to people being treated.

We observed the interactions of staff with people who use the service. This was person centred with good explanations from reception staff to new patients. People we observed receiving care appeared relaxed and expressed their understanding of treatment options discussed. We observed they had a good rapport with the practitioner and expressed gratitude on leaving.

We examined a sample of patient records and saw they included medical histories and current treatments for the people concerned. We saw the records also contained clear details of the treatment people received.

We saw that where people had arranged treatment privately they were given quotes

in advance, with a break down of the costs.

We saw the contact details for emergency treatment were displayed in the reception area of the practice.

The practice had effective systems in place for the decontamination of instruments. Staff had been trained to follow infection prevention and control precautions.

The practice was located over two floors and there was no passenger lift. The practice had disabled access to the building and once inside all services could be provided on the same level, as there are two surgeries on the ground floor. .

Staff had received training in protecting vulnerable adults, children and young people and recognising signs of abuse through oral examination. Staff were not fully aware of how to protect people through the use of the Mental Capacity Act 2005.