We carried out an announced comprehensive inspection on 17 October 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

The Health Centre Dental Practice is located at one end of the premises known as The Health Centre in Bradford on Avon.

There are separate entrances to the GP practice and dental practice. The Dental practice consists of four surgeries, a decontamination room, a waiting area, a reception area and an office. The decontamination room was finished to a high standard, with clear dirty/clean areas, ultrasonic washer and an autoclave and a separate hand wash facility. There are four dental consulting rooms, an office, reception area and a waiting area. The premises are all at ground floor level and are compliant with the Equality Act 2010, with appropriate separate access, but also the ability to transfer between the medical and dental practice if required.

The practice is situated within a large public car park with disabled spaces available, a mainline railway station on the opposite side of the car park and a regular bus service from neighbouring villages and towns.

Fees were displayed in information leaflets available in the practice for patients and on the website. The practice had a team of five dentists, one of whom is the principal dentist; one hygienist; eight qualified dental nurses, one of these nurses being the practice supervisor, and two trainee dental nurses, and two receptionists.

The principal dentist is the registered manager. Registered persons 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 practice is open: Monday - Friday, 09:00am to 1:00pm and 2.00 – 5.00pm and it is closed at weekends although there are some Saturday appointments by arrangement. Opening times and out of hours emergency arrangements are displayed on their website. Contact information is available from the practice telephone answering service.

We reviewed 36 CQC comment cards that had been left for patients to complete prior to our visit. In addition we spoke with three patients on the day of our inspection. Feedback from patients was positive about the care they received from the practice. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained to them so they could make an informed decision which gave them confidence in the care provided.

Patients we spoke with and the comment cards told us staff were kind, caring, competent and put patients at their ease. Three of the comment cards told us appointments were sometimes late and one of these told us they had not received information about the fees before treatment. We passed these comments to the registered manager.

Our key findings were:

• There were systems in place to help ensure the safety of staff and patients. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control and responding to medical emergencies.
• The dental practice had effective clinical governance and risk management processes in place; including health and safety and the management of medical emergencies.
• Patient care and treatment was delivered in line with evidence-based guidelines, best practice and current legislation. Patient dental records were electronic, detailed and comprehensive.
• The practice had a comprehensive system to monitor and continually improve the quality of the service; including through a detailed programme of clinical and non-clinical audits.
• The use of digital radiographs to help explain necessary treatment to patients while in the chair.
• Premises appeared to be mostly well maintained and visibly clean. Good cleaning and infection control systems were in place. The treatment rooms were well organised and equipped, with good light and ventilation.
• There were systems in place to check all equipment had been serviced regularly, including the air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.
• There were sufficient numbers of suitably qualified staff who maintained the necessary skills and competence to support the needs of patients.
• Staff were up to date with current guidelines, supported in their professional development and the practice was led by a proactive new principal dentist.

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

• Review the system for appraisal and the development of staff with the use of personal development plans separate to individual training and continuing professional development records.

• Review the repair programme for the upholstery and veneer in two surgeries and the replacement of linoleum in the decontamination room.

• Review the referral process with a view to obtaining additional information recording it to ensure follow up checks are completed after referral treatment.