We carried out this announced inspection on 17 November 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 Healthwatch that we were inspecting the practice. They did not provide any information.

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

Bicton Place Dental Practice is in Exmouth and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including spaces for patients with disabled badges, are available near the practice.

The dental team includes three dentists, three dental nurses, one trainee dental nurse, one dental hygienist, one receptionist and a practice manager. The practice has three treatment rooms.

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 collected 50 CQC comment cards filled in by patients and a further 89 on-line feedback replies. This information gave us a positive view of the practice.

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

The practice is open: Monday 8.00am - 1pm and 2pm - 5.30pm

Tuesday 8.00am - 1pm and 2pm - 5.30pm

Wednesday 8.00am - 1pm and 2pm - 5.30pm

Thursday 8.00am - 1pm and 2pm - 5.30pm

Friday 9.00am - 1pm and 2pm - 4.30pm

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 provider encouraged all staff to receive an annual seasonal flu vaccination. The provider reimbursed individual staff for the cost of the vaccine. This demonstrated a community minded approach to dentistry to help prevent spreading flu in the wider community.

We spoke with three patients who attended the practice. They told us they thought the service they received was “excellent.” They were very happy with the treatment and service they had received from the dental practice. One patient said “He is the best dentist I have ever had, and I have seen a few.”

Patients appreciated the patience, skills and professionalism of the dental team and said the dentists “took their time to explain the treatment they were receiving.” One person said “I am finishing a course of treatment. My dentist was very clear about what treatment was required and gave me several options including information about the cost. He was very clear but did not force me into any particular treatment. I thought this was very good so I knew what to expect.”

Patients told us that all consultations were performed in the privacy of the dental surgery, where confidentiality was maintained.

We were told the dentist and dental nurses were reassuring, especially with anxious patients. One patient said “He knows I hate the dentist, but he puts me at my ease.”

Patients said it was easy to get both routine and emergency appointments. Patients also told us that if they needed to cancel an appointment it was easy to reschedule.

Patients told us there was a hygienist at the surgery who was available for preventative treatment and oral health information.

The surgery was well maintained, clean and hygienic. Patients told us they were satisfied with the level of cleanliness at the dental practice. The surgery was accessible for people with mobility difficulties.

Patients were given opportunities to express their opinion of the service they received. Patients were able to complete an independent market research questionnaire. We were shown the written comments from this survey which showed the majority of patients were very satisfied with the service. We also saw the staff took action about the not so positive comments about waiting times.

Staff were well qualified and systems were in place to ensure staff kept their knowledge up to date. This included safeguarding and child protection procedures.

There were robust recruitment processes in place and effective quality assurance processes to make sure the services were continuously monitored.