We carried out an announced comprehensive inspection on 26th January 2017 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.

Background

Tewkesbury House Dental Practice is located in the centre of Tewkesbury and provides NHS and private treatment to patients of all ages. The practice consists of five treatment rooms, toilet facilities for patients and staff, a reception area, waiting areas, a staff room and an office.

The practice treats both adults and children. The practice offers routine examinations and treatment. There are seven dentists, two hygienists, five trainee dental nurses, two qualified dental nurses, three receptionists and a practice manager.

The practice’s opening hours are

8.00 to 20.00 on Monday

8.00 to 17.30 on Tuesday

8.00 to 20.00 on Wednesday

8.00 to 20.00 on Thursday

8.30 to 18.00 on Friday

Out of hours patients were directed to phone 111 who will direct them to the nearest dental access centre.

We carried out an announced, comprehensive inspection on 26th January 2017. The inspection was led by a CQC inspector who was accompanied by a specialist dental advisor.

Before the inspection we looked at the NHS Choices website. In the previous year there had been 21 comments about the practice which ranged from poor to excellent. The majority were positive and the overall rating was 4.5 stars. The practice had responded to all the comments on NHS Choices except one and they were in the process of responding to this one.

For this inspection 22 people provided feedback to us about the service. Patients were positive about the care they received from the practice. They were complimentary about the service offered which they said was very good and excellent. They told us that staff were professional, helpful, caring and friendly and the practice was clean and hygienic.

Our key findings were:

• Safe systems and processes were in place, including a lead for safeguarding and infection control.

• Staff recruitment policies were appropriate and most of the relevant checks were completed. Staff received relevant training.

• The practice had ensured that risk assessments were in place.

• The clinical equipment in the practice was appropriately maintained. The practice appeared visibly clean throughout.

•The process for decontamination of instruments followed relevant guidance.

• The practice maintained appropriate dental care records and patients’ clinical details were updated.

• Patients were provided with health promotion advice to promote good oral care.

• Written consent was obtained for dental treatment.

• The dentists were aware of the process to follow when a person lacked capacity to give consent to treatment.

• All feedback that we received from patients was positive; they reported that it was a caring and friendly service.

• There were arrangements for governance at the practice such as systems for auditing patient records, infection control and radiographs.

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

• Review the use of the re-sheathing device for hypodermic needles to ensure that the risk of a sharps injury is minimised.

• Review the recruitment procedures to ensure that two written references are obtained before new staff start work in the practice.

• Review the arrangements for keeping recruitment records in the practice to ensure that the registered manager has full information about prospective staff including written references.

• Review the arrangements for communication to include a hearing loop for patients with a hearing impairment.