We spoke with four patients by telephone. All were complimentary about the friendliness and professionalism of staff. One person commented “I have no hesitation in recommending the practice to friends and family. The service is second to none”. Another person said “It’s worthwhile travelling to the practice. They provide an excellent service”.

People who use the service told us the dentists provided them with treatment options and explained the different costs involved. They said they felt the practice gave them sufficient information to inform their decisions before they consented to treatment. People told us the dentist always explained the risk and benefits of various treatments and provided details of the expected outcome. We saw people's medical and dental health needs were accurately documented and updated at each visit.

We found the practice was clean, hygienic and well maintained. The staff followed appropriate infection control procedures to keep patients safe from harm. One patient commented “the practice is spotless”. Another said “the surgery always smells clean and fresh”.

Staff told us they felt well supported by management. They had an annual appraisal and were offered appropriate training at regular intervals to keep their skills up to date.

The practice effectively monitored the quality of services provided to patients. The practice carried out regular audits and health and safety checks.

We carried out this announced inspection on 18 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

Warwick House Surgery Ltd is in Bracknell, Berkshire and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including spaces for patients with disabled badges, are available at the practice or on the road nearby.

The dental team includes two dentists, two dental nurses, three dental hygienists, one receptionist and a Practice Manager. The practice has three ground floor treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 registered manager at Warwick House Surgery Ltd was the practice manager.

On the day of inspection we collected 31 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, a dental nurse, dental hygienist, receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from 9am to 5pm on Monday to Friday with the exception that every two weeks the practice opens at 8am on Tuesday and Friday.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were 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 line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

There were areas where the provider could make improvements. They should:

• Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review the practice’s audit protocols to ensure that audits of various aspects of the service, such as radiography are undertaken at regular intervals to help improve the quality of service. Practice should also ensure that where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.