As this was a follow-up inspection looking only at Regulation 20 (outcome 21: records), we visited the dental practice during lunchtime so as not to interrupt clinical care; there were no patients present.

We found that the provider had made improvements to records relating to the management of the dental practice and was in the process of systematically updating their records system to ensure people's medical records were accurate and accessible.

We spoke with three patients who told us that staff were "really friendly" and "[told] the truth -- what you need to know". We observed staff warmly greeting patients by name and having friendly conversations throughout the day. Patients told us that they had been attending the dental practice for years and their children were "happy and comfortable" because the dentists were "easy to understand." We saw that many of the staff and patients did not speak English as a first language, and both staff and patients often switched to other languages throughout the day. The provider told us that, collectively, staff speak 11 languages.

We reviewed the clinical records of five people, including children, older people and two private (fee-paying) patients. We saw that people received regular examinations and, where relevant, treatments. This included referrals to other professionals for further dental work, such as extractions under sedation. The dental practice was clean and had an effective system to limit cross-infection.

We saw that staff regularly explained treatment options to people and respected their choices. People's clinical records did not always reflect the care provided, such as obtaining verbal consent or checking medical history. We saw that other records relating to the management of the service were not fit for purpose. Staff received regular supervision and training, but records did not reflect the additional support provided to trainee dental nurses.