We carried out this announced inspection on 08 November 2018 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

Bupa Dental Care Worthing is located in Worthing, West Sussex and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. The practice has onsite parking.

The dental team includes seven dentists, an orthodontist, four dental hygienists, four dental nurses, two trainee dental nurses, three receptionists, a practice coordinator and a practice manager. The practice has six treatment rooms.

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 Bupa – Mill Road - Worthing is the practice manager.

On the day of inspection, we collected 18 CQC comment cards filled in by patients.

During the inspection we spoke with the two dentists, one dental nurse, one receptionist, the practice coordinator, the practice manager and the area compliance manager for the company. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday, Tuesday, Thursday from 8am to 8pm
• Thursday from 8.30am to 5.30pm
• Friday from 8am to 5pm

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 provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

At our last inspection on 19th March 2013 we found that the provider was non-complaint in one of the outcome areas. This was because there were inconsistencies in the way dentists recorded their discussions with patients about the options available to them. We asked the provider to send us an action plan outlining the actions they planned to take to ensure compliance. We received an action plan on 10 April 2013.

During this inspection we spoke with the practice manager, looked at eight patient records and reviewed management documents. We saw that the action plan had been implemented. From the records we saw that patients were given options and involved in discussions about their treatment. There were clear records of patient consent. This meant that before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

We spoke with five people who were using the service at the time of our inspection. All five said they were happy with the practice. One person said they could get appointments very quickly and that the dentist was very good with children. Another said they always saw the same dentist, which they liked. Another person said the service was “fantastic”. However, one person said that although they were very happy now, they felt that the company used to try too hard to get people to pay privately to see the hygienist. They said they had complained about this outside of the practice and that the company no longer did this.

All five people said that they were involved in decisions about their care, given clear information about the treatment options available to them and gave consent accordingly. All treatment prices were fully explained. They said that the dentist checked their medical histories at each visit. They said they would recommend the practice to others.

We also looked at patient satisfaction survey results, which revealed a 100% satisfaction rate for patient involvement, the quality of treatment and whether the patient would recommend the practice. We observed staff treating people with respect and warmth.