We carried out this announced inspection on 5 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 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Cheltenham House is in the centre of Cheltenham and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. On road car parking spaces and a public car park are available near the practice.

The dental team includes five dentists, three trained dental nurses and three trainee dental nurses who are support by an area nurse trainer, one dental hygienist and two receptionists. The practice has four 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 Cheltenham House has moved to another practice in the company and a new practice manager is in the process of applying for registration.

On the day of inspection we collected 17 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 two dentists, four dental nurses, two receptionists 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, Wednesday and Friday 08.30am – 5.30pm; Tuesday & Thursday 08.00am -8.00pm: Saturday 09.00am – 1.00pm. Closed Sundays.

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.

When we visited Cheltenham House Dental Surgery we spoke to the practice manager, the registered manager, four patients, a dentist, a dental nurse and the infection control nurse. We observed how reception staff communicated with patients in the waiting area. and we looked at the decontamination rooms where instruments were cleaned and sterilised.

The patients told us that the dentist had always asked about their medical history at every visit and explained their treatment to them. We looked at treatment plans and the information that had been given to patients about their treatment. Computerised treatment plans had been recorded that detailed each visit and also alerted clinicians to any health related concerns. We spoke to four patients they told us, "the dentist is wonderful", "extremely good dentist" and "very attentive and pleasant".

There were effective systems in place to reduce the risk of infection and clinical staff knew about the decontamination procedures. The systems in the practice had been regularly audited and patient’s views had been sought to help ensure that quality assurance was completed.