We carried out this announced inspection on 21 November 2017 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

The Beeches Dental Centre is located within a converted residential property in Worcester. The practice provides predominantly NHS dental treatments with private treatment options to patients of all ages.

The dental team includes two dentists, one dental hygienist, three dental nurses who also support with receptionist duties, one apprentice dental nurse who also works as a receptionist and a practice manager.

There is level access for people who use wheelchairs and pushchairs via a portable ramp at the front door. The ground floor of the practice consists of a reception area, a waiting room, a patient toilet, two dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments. On the first floor there is a small decontamination room for the sterilising and packing of dental instruments and two dental treatment rooms. Car parking spaces, including appropriate space for patients with disabled badges, are available in the dedicated on site car park.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 21 CQC comment cards filled in by patients and looked at the most recent patient survey undertaken in February 2017. Without exception, patients were positive about the quality of the service provided by the practice. They gave examples of the positive experiences they had at the practice and told us the practice team were fantastic, caring and always treated them well.

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

The practice is open:

Monday: 9am – 5pm

Tuesday: 9am – 5pm

Wednesday: 9am – 5pm

Thursday: 9am – 5pm

Friday: 9am – 2pm

Our key findings were:

• The practice was visibly clean and a contracted cleaning company were responsible for the day to day cleaning.
• The practice had infection control procedures which reflected published guidance.
• Staff had been trained to handle medical emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• 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 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 appointment system met patients’ needs. Patients could access routine treatment and urgent and emergency care when required.
• The practice had effective leadership. Staff we spoke with felt well supported by the principal dentist and practice manager and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided and displayed results in the reception area.
• The practice dealt with complaints positively and efficiently.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

During this inspection we spoke with a dentist, the practice manager and a trainee dental nurse. We also spoke on the telephone with six people who used the practice.

People who used the practice were very complimentary about the care and treatment they, and where applicable their family members received. People said the practice was: “Very good”. “It is fairly easy to get an appointment, if you have a problem you get in quite quickly”. People told us they were given information about their treatment and the dentist: “Has gone through it all very well”. There was medication and oxygen available for medical emergencies and staff were trained to know what to do if a person became unwell at the practice.

The practice was clean and people we spoke with confirmed that this was their experience too. There were suitable arrangements for the cleaning, sterilising and storing of instruments so that people were not placed at risk of infection.

The dental team were qualified and maintained their continuous professional development (CPD) as required by the General Dental Council (GDC) so that they knew how to support people.

The provider had systems of audits in place to enable them to monitor the quality of the service provided. This made sure that people received appropriate care and treatment. People were asked for their views about the practice and these were listened to. This made sure that people felt involved in their care and treatment.