We carried out an announced comprehensive inspection on 5 November 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

Warwick Road Dental Surgery provides general dental services on a NHS basis. The service is provided by the practice owner (provider), two associate dentists and one dental therapist. (A dental therapist works under the prescription of a dentist and can carry out preventative and routine restorative treatment). They are supported by a practice manager and three dental nurses (two of whom are trainees). The dental nurses also carry out reception duties. The practice is located on a main road in a residential area. The premises consist of a reception area and waiting room on the ground floor and one treatment room, office and decontamination room on the first floor. The practice is not accessible to people using wheelchairs. Opening hours are Monday, Wednesday, Thursday and Friday 9am to 5:30pm. The practice is closed on Tuesdays.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

22 patients provided feedback about the practice. We looked at CQC comment cards patients had completed prior to the inspection and we also spoke with three patients on the day of our visit. Patients were positive about their experience and they commented that they were treated with compassion and respect. They said that staff listened to them and were helpful.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained. They had access to an automated external defibrillator (AED). An AED is a portable electronic device that analyses life threatening irregularities of the heart including ventricular fibrillation and is able to deliver an electrical shock to attempt to restore a normal heart rhythm.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding and the management of medical emergencies.
• Staff received training appropriate to their roles.
• Patients told us they were treated with respect and dignity by staff. Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood. Patients commented they felt involved in their treatment and that it was fully explained to them.
• Patients were able to make routine and emergency appointments when needed.
• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• There were limited audits undertaken by the practice.

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

• Review the practice’s protocols and procedures for promoting the maintenance of good oral health giving due regard to guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’.
• Carry out audits of various aspects of the service, such as dental care records at regular intervals to help improve the quality of service.

We told the provider forty-eight hours before our visit that we were coming. During our visit, we spoke with the practice manager, two dental nurses, one dentist, one receptionist and six people who used the service on the telephone following our visit.

All six people we spoke with were complimentary about the service they had received. One person told us, "My treatment has been excellent’’. Another person told us, "Staff are very supportive and the dentists and nurse are lovely, they have always explained everything to me''.

People were involved in their treatment and options were explained to them. This meant a full discussion took place and people were given the information they needed to be able to make an informed decision about their treatment.

The provider had effective infection control procedures in place. This meant the risk of infection for people who used the service was minimised.

Staff received a range of training so that they had up to date knowledge and skills in order to treat people safely when they attended the practice.

There were systems in place to monitor how the practice was run to ensure people received a quality service. This meant people who used the service were asked their views about the service so the provider could use the information to improve.