We carried out an announced comprehensive inspection on 9 March 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

Victoria Street Dental Practice Ltd is located close to the centre of Crewe and comprises a reception and waiting room on the ground floor, a first floor waiting room, four treatment rooms, one of which is situated on the ground floor, a decontamination room, offices, storage and staff rooms. Parking is available on nearby streets. The practice is accessible to patients with disabilities, impaired mobility, wheelchair users and prams via one of the front entrances.

The practice provides general dental treatment to NHS patients of all ages, and general dental treatment on a private basis to patients of all ages.

The practice is open Monday to Friday 9.00am to 5.00pm.

The practice is staffed by six dentists, a practice manager, a clinical dental technician, a dental hygienist, a receptionist, and seven dental nurses, one of whom is a trainee, and another of whom is a dental nurse / receptionist.

One of the principal dentists and the Clinical Manager are the registered managers. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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.

We received feedback from 32 people on CQC comment cards about the services provided. Every comment was very positive about the staff and the service. Patients commented that the practice was clean and hygienic and they found the staff welcoming, friendly, and caring. They had trust in the staff and confidence in the dental treatments and said that they were always given clear, detailed and understandable explanations about dental treatment. Several patients commented that the dentists put patients at ease and listened carefully.

Our key findings were:

• The practice recorded and analysed significant events and incidents and received and acted on safety alerts.
• Staff had received safeguarding training and knew the process to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were available.
• Premises and equipment were clean, secure and properly maintained.
• Infection control procedures were in place and the practice followed current guidance.
• Patients’ needs were assessed and care and treatment were delivered in accordance with current legislation, standards and guidance.
• Patients received explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with dignity and respect and their confidentiality was maintained.
• The appointment system met the needs of patients.
• Services were planned and delivered to meet the needs of patients and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice took into account patient feedback but no formal system for obtaining feedback from patients, staff or stakeholders was in place.
• Staff were supervised, felt involved and worked as a team.
• Governance arrangements were in place for the smooth running of the practice and the practice had a structured plan in place to audit quality and safety.

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

• Review the practice’s sharps risk assessment having due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the practice’s fire risk assessment to ensure it is in accordance with legislation and current guidelines.
• Review the systems in place for obtaining, analysing and acting on feedback from patients, staff and stakeholders about the quality of care provided.

People using the practice told us they were happy with the service provided. They felt their dignity and privacy was being maintained and protected. They told us they were kept informed about the treatment they were receiving and the costs involved. Some of the comments received from people who use the service included; “The treatment is explained and I have no issues with the surgery”, “My whole family come here’ ‘All the staff are friendly and welcoming’.

People told us they found the staff were informative about the practice and services provided. They also told us they were asked for their views on the quality of service provided.

People told us they were given details about the treatment they required and the different treatment options available. They told us they had completed a form about their medical history and that they were regularly asked about changes to their health.

One person told us that, prior to using Victoria Street Dental Practice, they ‘had not been to a dentist for years’. They told us that during their initial visit the dentist had explained their treatment options, given them detailed information and had allowed time for them to make a decision about their treatment. This had ‘made them feel more comfortable and relaxed’ about attending the dental surgery.

All the people we spoke with told us that staff were very reassuring and helpful. They also said that the surgery was comfortable and accommodating and that appointments were flexible to meet their needs.

The people we spoke with during the inspection did not express any concerns about the cleanliness or safety of the environment.