We carried out this announced inspection on 16 November 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.

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

The Practice is located in Earl Shilton, a town in Leicestershire. They provide private treatment to patients of all ages and NHS services to children only.

There is level access for people who use wheelchairs and pushchairs with use of a portable ramp. The practice does not have on site parking but there are a number of free parking spaces available nearby in local car parks and on the street. Blue badge holders are permitted to park directly outside the practice.

The dental team includes three dentists (one of these is a visiting implantologist), three dental hygienists, five dental nurses and a receptionist. Practice management duties were shared amongst the team.

The practice has three treatment rooms, one of these are on the ground floor. The practice also rents a room to a podiatrist.

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 Earl Shilton Dental Practice is one of the principal dentists.

On the day of inspection we collected 36 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open: Monday and Thursday 8.30am to 6pm, Tuesday and Wednesday 8.30am to 5pm and Friday 8.30am to 4pm.

Our key findings were:

• Effective leadership from the provider was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and lifesaving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when they occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice was aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment, urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continuing professional development (CPD) by the practice.
• The practice had not received any complaints within the past twelve months but had systems in place to address complaints positively and efficiently.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• Governance arrangements were embedded within the practice.

We spoke with three people and five members of staff. We also reviewed two dental records and three staff files.

The people told us that their treatment had been explained and that they were able to make an informed decision about their treatment. One person told us:” I had some complex treatment recently. I was informed about my options, in fact I had quite a few discussions”.

The people we spoke with also told us their treatment was always explained to them and that their medical and medication history was always reviewed before every appointment and changes made where necessary.

We saw evidence of the completion of patient questionnaires, the collation of data and the actions taken. The registered manager explained that changes had been implemented following receipt of the suggestions.

During our visit we undertook a tour of the premises. The environment was clean, tidy and well maintained. We saw there were processes in place for the cleaning of the environment and the sterilisation of surgical equipment and instruments.

We saw that professional certificates were filed within the staff files we reviewed ensuring dentists and dental nurses were registered and suitably qualified to carry out their duties.