We carried out this announced inspection on 19 April 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 had access to remote specialist dental adviser support.

Whilst Castle Circus Health Centre houses outpatient hospital services and sexual health services, this report relates to dental services only provided at the location.

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

Castle Circus Health Centre is in Torquay and provides NHS assessment/dental care and treatment for people who may not otherwise seek or receive dental care. This includes vulnerable groups of people whose needs have prevented them accessing dental care through the General Dental Service, namely:

• Elderly, housebound or people with mental or physical health problems
• Special needs/learning disability
• Referred by GP/ Dentist/Social Services
• Emergency patients not registered with a dentist.

The service also provides treatment under inhalation and intravenous sedation. There is also a bariatric chair and wheelchair tipper at this site for the safe delivery of care for those who require this type of specialist equipment.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available at the practice.

The dental team includes an interim clinical director (who is also a dentist), four additional dentists, 11 dental nurses, two dental therapists, one practice manager (who is also a dental nurse) and three receptionists. The practice has three treatment rooms.

The practice is operated by Torbay and South Devon NHS Trust.

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

During the inspection we spoke with the clinical director, practice manager, dental nurse, dentist and dental therapist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 8:45am to 4.30pm.

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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and 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 dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.