We carried out this announced inspection on 21 June 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

Oasis Dental Care – Whitehaven is situated on the habour side in Whitehaven 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, including spaces for patients with disabled badges, are available near the practice.

The dental team includes three dentists, six dental nurses, one dental hygienist therapist and two receptionists. The practice has four treatment rooms all situated on the ground floor of the building.

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 Oasis Dental Care Whitehaven was the practice manager.

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

During the inspection we spoke with one dentist, one dental nurse, one dental hygiene therapist, two receptionists, the practice manager and the regional clinical compliance officer. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday 08.00am to 07.00pm

Friday 08.00am – 05.00pm.

The practices closes for an hour daily to enable staff to have their lunch.

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.

We carried out an announced comprehensive inspection on 3 March 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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 offers NHS primary care dentistry to adult patients and children. The practice is owned by Oasis Dental Care (Central) Limited. There is one dentist, one therapist, five dental nurses, three receptionists and a practice manager who is also a dental nurse.

The practice is open Monday to Thursday from 8.00am to 7.00pm, and Fridays from 8.00am to 5pm. Due to the number of patients needing to be seen and the reduced number of dentists the practice is also opening on a Saturday and Sunday from 7.45am to 3.45pm.

There is an identified registered person for the practice. Registered persons 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 practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Before the inspection 14 patients provided feedback about the service. The majority of these were very positive about the practice however there was an underlying concern that the lack of dentists did result in long waiting times between appointments and appointments being cancelled.

Our key findings were:

• There was an effective complaints system.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
• There was not sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines.
• Due to staff shortages patient care and treatment was not planned and delivered in line with evidence based guidelines and current regulations. Following the inspection the provider submitted an action plan which showed that two locum dental staff had been allocated to assist in the practice to ensure that patients received their treatment in a timely manner. A further two dentists were in the process of being recriuited to address this concern in the long term.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients could access urgent care when required.
• The practice was well-led, staff felt involved and supported and worked well as a team.
• The governance systems were effective.
• The practice sought feedback from staff and patients about the services they provided.

There were areas where the provider could make improvements and should:

• Review the use of dirty instrument transportation boxes to ensure these are not overfilled and can be sealed.
• Review the process to ensure there are sufficient numbers of staff to meet patients care and treatment needs.

"Lovely dentist. Really friendly and professional. Reassuring too".

"Friendly, helpful service, lovely dentist. First class".

"Always a great service".

"I waited a long time to get on the list but I am very happy now I am getting such good treatment. One of my family comes here too and was referred to Cumberland Infirmary for treatment and that was really marvellous. I feel we have had good treatment all round".

"Kind attention...felt very reassured".