We carried out this announced inspection on 18 April 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

Crownhill Dental Practice (Mr. Ramin Ordi) is in Plymouth and provides mainly private treatment to adults. Some NHS is also carried out.

The practice is situated on the first floor of a commercial street, accessed by a flight of stairs. Public car parks are nearby.

The dental team includes two dentists, five dental nurses, two dental hygienists, a receptionist and a cleaner. The practice has two treatment rooms.

There are two dentists, who have individual registrations with CQC at the practice. Mr. Ramin Ordi has a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 27 CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Thursday (dentists only) 8.30am – 5.30pm.
• Wednesdays (hygienists only) 8.30am – 5pm (and the last Friday of each month).
• Friday (dentists only) 8.30am – 3pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider had not received any complaints in the last 12 months.
• The provider had suitable information governance arrangements.

During our visit we met with four people who were attending for treatment or examination, Mr Ramin Ordi, the dentist, and two staff on duty.

People told us that they found the dentist and staff to be pleasant and welcoming. They said the dentist was very reassuring, and explained the treatment they needed very well.

The practice was located on the first floor, with access via a flight of stairs. There was no lift available. A second bannister had been fitted to give support to people climbing the stairs. We saw from a patient survey recently carried out that people appreciated this addition. One person told us they found the stairs difficult but they did not want to change and go to a different dentist, as they had “no problem with this one”.

People said they had been asked about their health and medical history. “Every time I come he (the dentist) asks about my medicines” we were told. This showed that the dentist ensured the treatment provided was suitable for each person with respect to their general health.

We found that the process for cleaning instruments was compromised by sharing space with clinical waste. We found that records were not stored securely, and that the complaints procedure was not available for people to see. The dentist took immediate action with respect to these issues.