We carried out an announced comprehensive inspection on 29 September 2015 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

Walsall Family Dental Practice offers both NHS and private dental treatment. The practice treats adults and children. The practice provides primary dental services to mainly NHS patients. The practice is open Monday to Thursday between the hours of 8am and 8pm and on Fridays between the hours of 8am to 5pm. It was also open on a Saturday from 9am to 2pm.

The premises consists of a waiting area on the ground floor, a reception area, an accessible treatment room on the ground floor and three treatment rooms on the first floor. There is also a separate decontamination room.

The practice was owned through a partnership of two people who did not work at the practice. The staff at the practice consists of four associate dentists, eight dental nurses and a practice manager. All the nurses also work as receptionists. On the day of the inspection the practice manager was supported by a ‘Care Quality Commission (CQC) manager ‘who worked at other sites owned by the partnership.

The practice manager is the registered manager. 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 spoke with three patients during the inspection. Two of the patients told us that they were satisfied with the services provided, that the dentists provided them with clear explanations about their care and treatment, the options, costs and that all staff treated them with dignity and respect. One patient was returning to the practice after a period of 15 years. We received five comments cards which were positive about the service provided and the staff.

Our key findings were:

• The practice recorded and analysed significant events and complaints and cascaded learning to staff.
• Staff had received formal safeguarding training and knew the processes 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 appropriate medicines and life-saving equipment were readily available.
• Infection control procedures were in place and the practice followed published guidance.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation. However, not all patients received a treatment plan.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it. However, they were not always documented.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and the practice was working to keep waiting times to a minimum.
• There was an effective complaints system.
• The practice staff felt involved and worked as a team.
• Governance systems were effective and there was a range of clinical and non-clinical audits to monitor the quality of services.
• The practice sought feedback from staff and patients about the services they provided.

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

• Record all incidents as well as accidents to facilitate learning and prevent re-occurrence

• Develop mechanisms to review if the cleaning was being done effectively.
• Carry out timely appraisals of all relevant staff.
• Develop dedicated consent forms for treatments.

• Provide treatment plans to all patients.

Document discussion and learning from complaints in minutes of team meetings so that staff members on leave would be able to update themselves.