We carried out this announced inspection on 7 March 2019 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

Centre for Dentistry – Calcot is based in a Sainsbury Supermarket near Reading and provides private treatment to patients of all ages.

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

The dental team includes seven dentists, three dental nurses, two trainee dental nurses, five receptionists and a practice manager. The practice has two 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.

At the time of inspection there was no registered manager in post as required as a condition of registration. We noted the provider allocated one of its registered managers from another practice while a new registered manager was appointed.

On the day of our inspection we collected 17 CQC comment cards filled in by patients and obtained the views of five other patients.

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

The practice is open Monday to Thursday from 8.00am to 8.00pm and Friday and Saturday from 8am to 6.00pm.

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.
• Improvements were needed to 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 had systems to monitor staff training.
• 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.
• Improvements were needed to ensure audit action plans reflected the results of audits.
• All of the shortfalls identified have been addressed since our visit.

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

• Review the provider's registration conditions to ensure the regulated activities at Centre for Dentistry – Calcot are managed by an individual who is registered as a manager.

We found that patients were informed about their treatment needs and the associated costs and signed the treatment plan to confirm their consent.

Appropriate dental and oral examinations were carried out and people’s medical and health history taken. This information was updated at subsequent appointments within the computerised patient record system.

Patients were very happy with the service provided. Patient comments included “very reassuring”, “very thorough” and “very professional”.

Staff had been trained in child protection and safeguarding vulnerable adults and the practice provided information to staff about their responsibilities.

The staff within the practice had attended appropriate training and continuous professional development to maintain and update their skills and knowledge.

The practice manager and registered manager had systems to monitor the on-going performance within the practice and for seeking the views of patients.