We carried out an announced comprehensive inspection on 3 February 2017 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Wymans Brook Dental Practice is a dental practice providing private treatment mainly for adults but does treat some children.

The practice is based in a former domestic property situated above a row of shops, in a suburb of Cheltenham. The practice has one waiting room, an office, small reception room, one treatment room and a separate room for the cleaning, sterilising and packing of dental instruments. Although the practice was on the first floor and not accessible to patients with limited mobility, the practice made alternative arrangements for these patients to be seen in other services.

The practice employs one principal dentist and two dental nurses who also act as receptionists or manage the decontamination processing, when not supporting the dentist at the chairside.The practice opens 9am to 1pm and 2pm to 5.30pm Monday to Thursday and 9am to 1pm and 2pm to 5pm on a Friday.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. This is provided by an out-of-hours service. If patients called the practice when it was closed, an answerphone message gave the telephone number patients should ring depending on their symptoms.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

Before the inspection, we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 36 patients. In addition we spoke with two patients on the day of our inspection. Feedback from patients was positive about the quality of care, the caring nature of all staff and the overall high quality of customer care. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by the principal dentist.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• Premises appeared well maintained and visibly clean.
• Infection control procedures were effective and the practice followed published guidance.
• There were systems in place to check all equipment had been serviced regularly, including the autoclave and the X-ray equipment.
• The practice had a safeguarding lead professional and effective processes in place for safeguarding adults and children.
• There was a policy and procedure in place for recording adverse incidents and accidents.
• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.

• The dentist used Loupes – these enable the clinician to have a magnified view of the operation site thus enabling accuracy of treatment.

• The practice had a system to monitor and continually improve the quality of the service; including through a programme of clinical and non-clinical audits.
• Patients could access treatment and urgent and emergency care when required.
• Staff had received training appropriate to their roles and were supported in their continuing professional development by the principal dentist.
• Information from 36 completed Care Quality Commission (CQC) comment cards and speaking to patients gave us a positive picture of a friendly, caring, professional and high quality service.
• The practice reviewed and dealt with complaints according to their practice policy.

When we visited Wymans Brook Dental Practice we spoke with four patients, two dental nurses, the dentist and the practice manager. We looked at treatment plans and there was a detailed record of completed dental assessments and treatment options discussed with the patient. Patients were pleased with the care and treatment they received and found the staff friendly and polite. Patients told us, "quite happy here I always feel welcome", "very good my filling was pain free" and "the staff are very helpful". There was a practice information leaflet available which had detailed guidance for patients and a price list was displayed in the waiting room. There was a comments box where patients could leave their views.

Staff were trained in safeguarding adults and child protection. There were procedures for staff to follow to protect children and adults from abuse.

The practice was clean throughout and instruments were cleaned and sterilised effectively. Staff followed infection control and decontamination of instruments procedures to help protect patients from the risk of infection. Patients told us the practice was always clean.

Quality monitoring audits were completed to ensure systems were effective and action was taken where improvements were required. The practice used patients surveys to monitor the quality of the service. Complaints were addressed and action taken recorded.