We carried out this announced inspection on 11 April 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 carried out by two CQC inspectors who had remote access to 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.

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

Chard Dental Centre is in Chard, Somerset and provides NHS and private treatment to patients of all ages.

There is no level access for people who use wheelchairs and pushchairs. There are a set of stairs, and a stair lift, to access the practice, which is situated on the first floor. Public car parking spaces are available near the practice.

The dental team includes four dentists (one of whom is a locum covering a vacant full-time position), one dental nurse, four trainee dental nurses and two receptionists. There is also a practice manager, who is a qualified dental nurse. The practice has three 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 Chard Dental Practice was the practice manager.

On the day of inspection we collected 26 CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, two dental nurse, three trainee dental nurses, one receptionist, the company regional regulatory office and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Friday 8am – 6pm.

Our key findings were:

• The practice appeared clean.

• 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 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.

During our inspection we spoke with five people who used the service, two of the four dentists who were on duty the day we visited and one dental nurse, who also showed us the process of cleaning and sterilising the dental instruments. We looked at four treatment records of people who used the service and found they detailed how the dentist had planned and delivered the person’s dental treatment.

People we spoke with told us they thought they received good dental treatment from the dentists. They were confident in their abilities and told us if they were anxious about receiving dental treatment then the dentist was sensitive and considerate. Some comments from people were; “I think of my dentist as a gentle giant, they put me at ease” they said the dentist made them feel better receiving dental treatment after a bad experience with another dentist. Another person said “very nice person, very good, I don’t like coming to the dentist but they put me at ease and are very considerate”.

The practice was following appropriate guidance in relation to infection control as far as reasonably practicable with the restrictions of the practice, with the exception of not having a double sink/bowls in place to clean and rinse the dental instruments. The provider and manager had systems in place to assess and monitor the service. Staff knew what their role was to protect vulnerable adults and children from abuse.