We carried out this announced inspection on 4 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.

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

Billingshurst Dental Practice is in Billingshurst and provides NHS and private treatment to patients of all ages.

The practice is located on four floors including a basement and loft and is currently accessed via steps from the road. The practice has recently undergone significant buildings works and modernisation with an increase in the number of treatment rooms, the addition of a separate decontamination room and a wheelchair accessible toilet. Patients will shortly be able to use a step free and fully accessible entrance at the back of the premises. There will also be the addition of a further wheelchair accessible treatment room. The practice has its own on-site parking.

The dental team includes four dentists, one foundation dentist, seven qualified dental nurses, one trainee dental nurse, two dental hygienists, four receptionists, an administrator and a practice manager who are both qualified nurses. The practice also had two visiting specialists. The practice has five treatment rooms.

The practice is owned by a partnership 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 Billingshurst Dental Practice was the practice manager.

On the day of inspection we collected 50 CQC comment cards filled in by patients and spoke with nine other patients. This information gave us a positive view of the practice.

During the inspection we spoke with Two dentists, three dental nurses, two receptionists, the administrator 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, Wednesday to Friday from 8.30am to 5pm and Tuesdays from 8.30am to 6pm. The practice opens one Saturday a month from 8.30am to 12pm and retains flexibility to open on more Saturdays if patients require this.

Our key findings were:

• The practice appeared 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.

We spoke with four patients who all told us they were happy with the dental treatment received at the practice. One patient said “I am perfectly happy”. Another told us "The staff are very welcoming". People told us they were treated with courtesy.The patients told us that treatments were explained to them and that they were aware of charges. All felt they would be able to raise a concern should the need arise.

We spoke with two dentists, one of whom was the registered provider, two dental nurses, and two receptionists. All were able to demonstrate that all staff were trained and competent to do their job. The practice manager was spoken with and she made available any documentation we wished to see on the day.

Patients were protected by the training of staff in safeguarding matters and infection control.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.