We carried out this announced inspection on 30 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

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

Amble dental practice is in Northumberland 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 are available near the practice.

The dental team includes the seven dentists (one being the principal dentist), the practice manager, nine dental nurses, one dental hygienist, two dental therapists and three receptionists. The practice has five treatment rooms located over two floors.

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 Amble dental practice was the principal dentist.

On the day of inspection we collected 27 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the principal dentist, two associate dentists, the practice manager, three dental nurses and a dental therapist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday – Wednesday 0830 -1730

Thursday 0830 – 1900

Friday 0830 – 1700

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.
• The practice was involved in various research and educational programmes, including training for newly qualified dentists.
• Care was provided as part of the NHS prototyping pilot to increase access and improve dental health.
• Staff attend community nurseries and schools to promote oral health and prevention.

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

• Review the current Legionella risk assessment and implement the required actions including the monitoring and recording of cold water temperatures.
• Review the practice’s system for documentation of incidents, and actions taken in response to incidents, with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the practice's waste handling protocols to ensure waste is stored in accordance with relevant regulations taking into account guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Review the practice’s protocols for domiciliary visits taking into account the 2009 guidelines published by British Society for Disability and Oral Health in the document “Guidelines for the Delivery of a Domiciliary Oral Healthcare Service”.

We spoke with three people who used the service to find out their opinions of the treatment provided. Because the practice was busy we contacted these people by telephone. Everyone we spoke with was complimentary about the treatment provided.

People told us they were happy with the service provided. One person told us, “It’s excellent. I’ve had no problems and I’ve been going there 11 years. I always see the same dentist” and “I’m disabled and the practice is split over two floors, but they always arrange for me to be seen in a surgery downstairs.” Another person said they had chosen to remain with the practice even though they had moved away from the area.

General comments included, “It’s all smashing. I’ve no problems,” “It’s the best dentist I’ve ever been to and I’ve not been to any bad ones. It’s just better, better surgery, clean, just better everything” and “I think it’s very good, very clean and very efficient. I’m very impressed.”