We carried out an announced comprehensive inspection on 26 July 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

Warrington House Dental Practice is located in Brislington, a residential area of Bristol, and provides NHS and private treatment to patients of all ages. The practice consists of three treatment rooms, toilet facilities for patients and staff, a reception/ waiting area and a staff room.

The practice treats both adults and children. The practice offers routine examinations and treatment. There are five dentists.

The practice’s opening hours are

8.00 to 17.00 on Monday

8.00 to 19.00 on Tuesday

8.00 to 17.45 on Wednesday

8.00 to 17.30 on Thursday

8.45 to 15.00 on Friday

The dentists operate an on-call system out of hours.

We carried out an announced, comprehensive inspection on 26 July 2016. The inspection was led by a CQC inspector accompanied by a dental specialist advisor.

Before the inspection we looked at the NHS Choices website but there were no reviews.

For this inspection 36 people provided feedback to us about the service. Patients were positive about the care they received from the practice. They were complimentary about the service offered which they said was good or excellent. They told us that staff were professional, efficient, helpful, polite, caring and friendly and the practice was clean and hygienic. We received one negative comment about the reception staff sometimes being abrupt.

Our key findings were:

• Safe systems and processes were in place, including a lead for safeguarding and infection control.

• When recruiting staff the relevant checks were completed but not within timescales identified in current guidance. Staff received relevant training.

• The practice had ensured that risk assessments were in place and that they were regularly reviewed.

• The clinical equipment in the practice was appropriately maintained. The practice appeared visibly clean throughout.

•The process for decontamination of instruments followed relevant guidance.

• The practice maintained appropriate dental care records and patients’ clinical details were updated.

• Patients were provided with health promotion advice to promote good oral care.

• Consent was obtained for dental treatment.

• The dentists were aware of the process to follow when a person lacked capacity to give consent to treatment.

• All feedback that we received from patients was positive; they reported that it was a professional, helpful, caring and friendly service.

• There were arrangements for governance at the practice such as systems for auditing patient records, infection control and radiographs.

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

• Review the recruitment procedures to ensure Disclosure and Barring checks and two written references are obtained before new staff start work in the practice.

• Review the training for medical emergencies to include role play to give staff the opportunity to learn how to work together in the event of an emergency.

• Review the process for checking the fire safety measures to include routine checks to ensure all the safety measures are working properly.

• Review the arrangements for checking the fridge temperatures to make sure they are kept at the correct level for the storage of medicines.

• Review the arrangements for keeping prescriptions to introduce a process of checking to ensure none are missing.

• Review the procedure for taking X-rays so that they are always graded to assess the quality.

• Review the training and development for dentists about the Mental Capacity Act 2005 and capacity and consent so that all dentists understand about adults’ and children’s capacity to consent.