We carried out an announced comprehensive inspection on 13 January 2016 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

The Bull Ring Dental Practice is situated on the edge of Worcester city in a converted period property and provides NHS and private dental care. The practice has four dentists, one dental hygienist and six dental nurses two of whom are also the joint practice managers. The clinical team are supported by two receptionists. The practice has four dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments used in the first floor treatment rooms. Instruments used in the ground floor treatment rooms were processed in one of those rooms. The reception area and waiting room are on the ground floor.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to use to tell us about their experience of the practice. We collected 26 completed cards. Without exception patients were positive about the quality of the service provided by the practice. They gave examples of the positive experiences they and members of their families (including children) had at the practice and told us the practice team were professional, caring and attentive. Several patients commented that the dentists listened to them and explained their treatment in a way they could understand. Patients wrote that they had a high opinion of the practice and would not consider going elsewhere. Over a third mentioned that they always found the practice clean and hygienic. We saw the practice’s NHS Friends and Family results for April to October 2015. Out of a total of 122 responses 105 said they were ‘extremely likely’ to recommend the practice, nine said ‘likely’ and five selected a neutral response. Just three said they would be ‘unlikely’ to recommend the practice.

Our key findings were:

• Patients who completed CQC comment cards were all positive about the practice team and the care and treatment provided.

• The practice had an established process for reporting and recording significant events and accidents to ensure they investigated these and took remedial action.
• The practice was visibly clean and a number of patients commented on their satisfaction with hygiene and cleanliness.
• The practice had well organised systems to assess and manage infection prevention and control.
• The practice had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• The practice had recruitment policies and procedures and used these to help them check the staff they employed were suitable. The practice obtained the correct information for new staff but their written policy and procedures did not fully reflect the requirements of legislation.
• Dental care records provided comprehensive information about patients’ care and treatment. They contained evidence that the dentists took patients general health into account and communicated appropriately with other health professionals.
• Staff received training appropriate to their roles and were supported in their continued professional development.
• Patients were able to make routine and emergency appointments when needed.
• The practice had systems including audits to assess, monitor and improve the quality and safety of the services provided.
• The practice had systems to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors.

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

• Review the practice’s recruitment policy to fully reflect the requirements of Regulation 19(3) and Schedule 3 of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014.

We spoke with five people who had recently used the practice. We also spoke with two practice managers, three dental nurses and a receptionist.

People who used the practice told us that they were happy with the quality of treatment they had received. One person told us: “I’m very happy. I’ve been a patient there for a number of years and that speaks volumes.” Another person said: “They’re gentle and efficient. The work’s reliable.”

People felt they were given enough information about their treatment options and the relevant fees, and were able to ask all the questions they wanted to.

People were protected from the risk of abuse because staff had been trained how to recognise signs of abuse and knew how to report concerns.

We found that people received care and treatment in a clean and hygienic environment. People we spoke with had no concerns about the cleanliness of the practice.

We found that staff were supported to deliver care and treatment safely and to an appropriate standard.

We looked at records which showed that the provider was regularly monitoring the quality of its service.