We carried out this announced inspection on 23 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.

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

The Practice is located in Bourne, a market town in the South Kesteven district of Lincolnshire. The practice provides mostly NHS treatment to patients of all ages. It also provides some private treatments. At the time of our inspection, the practice was not accepting any new NHS patients for registration.

There is level access for people who use wheelchairs and pushchairs. There is no car parking available on site, but there are three local car parks and on street parking near to the practice. This includes parking for blue badge holders.

The dental team includes 11 dentists, 13 dental nurses, three trainee dental nurses, two dental hygienists, five receptionists, four cleaners and two practice managers who share a dual role. The practice has 11 treatment rooms; four of which are on the ground floor.

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 managers at Bourne Dental Practice are the two partnership members.

The partnership also provides a second dental service of the same name at a location in Coningsby.

On the day of inspection we collected 24 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, three dental nurses, one dental hygienist, three receptionists and both of the practice managers. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday and Wednesday from 9am to 7pm, Tuesday and Thursday 9am to 5.30pm, Friday 9am to 3.30pm and Saturday 9am to 12.30pm.

Our key findings were:

• Effective leadership from the provider and practice managers was evident.
• Staff had been trained to deal with emergencies. Whilst most appropriate medicines and lifesaving equipment was readily available in accordance with current guidelines, we noted some exceptions.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when they occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice was aware of the needs of the local population and took most of these into account when delivering the service.
• Patients had access to routine treatment, urgent care when required.
• Staff received training appropriate to their roles and were supported in their continuing professional development (CPD) by the practice.
• The practice dealt with complaints positively and efficiently.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• Governance arrangements were embedded within the practice.

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

• Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.