We carried out this announced inspection on 18 April 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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.

Background

Stoke Bishop Dental Centre is in Bristol and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs, with ramp assistance. Car parking spaces, including blue badge holders, are available near the practice.

The dental team includes four dentists, two dental nurses, one lead dental nurse, one trainee dental nurse, two dental hygienists, one practice manager/dental nurse, one project manager and one patient clinical manager. The practice has three treatment rooms.

The practice is owned by a partnership and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Stoke Bishop Dental Centre was the principal dentist.

On the day of inspection we collected 45 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with two dentists, two dental nurses, one lead dental nurse, one trainee dental nurse, one practice manager/dental nurse and one patient clinical manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9.15am to 6pm

Tuesday 8am to 6pm

Wednesday and Friday 8am to 4.30pm

Thursday 8am to 5:30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment, in particular the fitting of rectangular collimators to X ray units.
• Review the practice's Legionella risk assessment, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’, in relation to the use of mobile air conditioning units.

People that we spoke with on the day of our visit were happy with the service provided by Stoke Bishop Dental Practice. We received a number of positive comments about the practice. One person said that they were "very happy". Another person commented that there was no pressure to accept any particular treatment.

People said that they were able to make appointments when they needed them. One person was pleased to have been offered an appointment on the same day for an urgent issue. Another person said that previously they had called the practice on a bank holiday and arrangements had been in place to be seen at another surgery.

Staff were supported in their continuing professional development, because they had opportunity to access a variety of online courses. Staff told us that they enjoyed doing these and found them useful. Staff were aware of their responsibilities to safeguard children and vulnerable adults and there were policies in place to support them in this.

Patients using the service were treated in a practice that followed guidance set out in the Health Technical Memorandum 01-05 (HTM). This is the guidance that all dentists must follow in order to ensure that their decontamination and sterilising procedures are safe and minimise the risk of cross infection.