We carried out this announced inspection on 4 May 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

Tupsley Dental Practice is located to the north of the city of Hereford and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. The practice has ample car parking available for patients at the rear of the building.

The dental team includes four dentists, five dental nurses, two dental hygienists, a dental therapist, four receptionists and a practice manager. The practice has five treatment rooms, four of which have decontamination areas and two of which are on the ground floor.

The practice is owned by the two principal dentists 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 12 CQC comment cards filled in by patients and spoke with two patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses, a dental hygienist, a dental therapist, two receptionists 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, Wednesday, Thursday and Friday: 9am – 5.45pm

Tuesday: 9am – 7.30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had good infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were readily 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 accordance with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Effective leadership was provided by the two principal dentists and an empowered practice manager. Staff felt involved and supported and worked well as a team.
• The appointment system met patients’ needs.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt well supported by the practice manager and principal dentists and were committed to providing a quality service to their patients by ensuring their patients were their main priority.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• Information from 12 completed Care Quality Commission (CQC) comment cards and conversations with two patients gave us a positive picture of a professional, caring, friendly and high quality service.

The practice was welcoming and people we spoke with felt that they were treated in a considerate and respectful way. One person we met said, "it is excellent here" and the five people we spoke with on the telephone also gave us a positive view of the practice.

People's treatment was planned and discussed with them and based on their assessed needs. People told us they were given clear information about the treatment they needed and the cost of this.

The practice was clean when we visited and people we spoke to confirmed that this was their experience too. We saw there were suitable arrangements for the cleaning, sterilising and storing of instruments. Staff were knowledgeable about these procedures and described them to us confidently.

The dentists and staff were qualified and maintained their continuous professional development (CPD) as required by the General Dental Council (GDC). The dentists were planning to re-start annual staff appraisals to help them make sure that the whole team's training and development needs could be identified and addressed in a planned way.

The provider was consulting people who used the service by sending annual surveys to gain their views about the quality of the service they received. We saw evidence that the small number of complaints received had been responded to constructively and where appropriate people had been given an apology. People we spoke with said they would feel able to raise concerns if they had any.