We carried out this announced inspection on 14 February 2019 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 not providing well-led care in accordance with the relevant regulations.

Background

21 Church Street Dental Practice is in Woodbridge and provides private treatment to adults and children.

There is a portable ramp available to provide access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available in car parks near the practice.

The dental team includes one dentist, one dental nurse and one receptionist. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we received feedback from 18 patients.

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

The practice is open: Monday to Thursday from 9am to 5pm.

Our key findings were:

• We received positive comments from patients about the dental care they received and the staff who delivered it.
• The practice staff had infection control procedures which reflected published guidance. We found the practice did not have records of six monthly infection control audits. The most recent audit was dated 2017. The audit had not identified the risks associated with damaged work surfaces in the treatment room.
• Staff knew how to deal with emergencies. We noted the practice was missing some essential medical emergency equipment such as an ambubag and clear face masks. Following the inspection, the practice sent confirmation that these had been replaced.
• Risk assessments to identify potential hazards were limited.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. The receptionist had not received any safeguarding training.
• Audits to assess the quality of service were limited.
• Staff treated patients with dignity and respect. We found that not all dental care records were stored securely.
• The practice had some arrangements to ensure the safety of the X-ray equipment. There was no evidence of mechanical and electrical checks of the X-ray equipment.
• We noted the dentist did not use rectangular collimation.
• We noted the dentist did not use rubber dam when providing root canal treatment.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.

We identified regulations the provider was not meeting. They must:

• Ensure care and treatment is provided in a safe way to patients.
• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.