We examined five record cards and saw evidence of consent to treatment. We found that the patients were provided with a series of treatment options and the cost of each treatment option. Two patients consented and gave us interviews. One patient told us, "Jane explained my orthodontic treatment to me really well."

We found that medical alerts would be flagged up on opening a patient record to alert all staff. We also observed a protocol was in place for regularly updating a patient's medical history. This meant that the staff were aware of any relevant medical information that may effect the patient's treatment and ensured patients were safe during a consultation.

We found that the practice was clean and well maintained. The patients we talked to told us this. We found further evidence in a patient satisfaction survey that patients considered the practice was a clean and safe environment. We found that all necessary steps had been taken to reduce the risk of cross infection.

We found there was an appraisal system in place and we saw these records in the staff personal files. The dental nurse/receptionist told us that that the provider was supportive in her professional development. She said, "Jane is fully supportive to me."

We found that that the patient records contained full and contemporaneous notes. The standard of record card keeping followed current best practice. We found good evidence of a safe environment in the clinical governance file.