We carried out this announced inspection on 11 December 2018 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

Euston Place Dental Practice is in Royal Leamington Spa and provides predominantly private treatment with a small NHS provision to adults and children. The services are provided by six individually Care Quality Commission registered providers at this location. This report only relates to the provision of general dental care and specialist services provided by Mr. Paul Mulligan. Additional reports are available in respect of the general dental care and specialist services which are registered under the following providers; Dr Manvinder Thandi, Mr Charles Buckle, Dr Douglas George Watt, Westvere Limited and Macvander Ltd.

There is a large ramp at the rear of the building to provide access for people who use wheelchairs and those with pushchairs. Car parking spaces, including some for blue badge holders, are available in pay and display car parks near to the practice.

The dental team includes six dentists, ten dental nurses, one trainee dental nurse, one dental hygienist, three dental hygiene therapists, four receptionists, two administrators and one practice manager. The practice has eight treatment rooms.

The practice is owned by an individual who is one of the four the principal dentists there. They have 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 68 CQC comment cards filled in by patients.

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

The practice is open:

Monday to Thursday: from 8.15am to 5pm

Friday: from 8am to 2pm

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. Appropriate medicines and life-saving equipment were available with the exception of face masks for the self-inflating bags. These were ordered within 48 hours of our visit.
• 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. Safeguarding contact details and flow charts were displayed in the staff kitchen.
• The provider had 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. They routinely referred patients to their dental hygienist and hygiene therapists through a clear care pathway.
• The appointment system took account of patients’ needs. Patients could access routine treatment and urgent care when required.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided. Information from 68 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a gentle, friendly and high-quality service.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

During our visit on 31 January 2012, we spoke with one of the dentists at the practice, the practice manager and two dental nurses.

We spoke by telephone to seven people who attend Euston Place Dental Practice. They were all positive about the service they receive. Some had been going to the practice for a long time. They told us, “My dentist and nurse are outstanding, they are very professional,” and “Everyone is very welcoming and courteous.”

We asked people about the availability of appointments and if they had to wait over their appointment time to be seen. People told us, “I never have to wait, I am always seen within five minutes” and “I always get seen on time.”

Several people made a point of commenting that the team was polite and friendly and one person said they appreciated that the staff knew them by name. One person told us that, ”the reception staff are wonderful,” They added that they have noticed other people being dealt with politely too. Several people said they thought it was a professional practice and had recommended it to their relatives and friends.

We asked people if they had ever had to make a complaint. People we spoke with said they would speak to the dentist if they were unhappy with anything, but had never had cause to do this. One person told us, “No, I’m very lucky to have such a well run dental practice, I feel very fortunate.”

We undertook a tour of the practice. We looked at systems in place and asked people about the cleanliness and hygiene practices.

People we spoke with said everything always looked clean and that there were good standards of personal hygiene. One person said, “It’s spotless.”

We asked how people received treatment as an emergency. The dentist explained that he held a slot for emergency appointments but they allowed people to come in whenever they needed, on the understanding that they had to wait.

Staff spoken with told us that they were very happy working at the practice and that they felt they received a good level of training and support from the dentists and practice manager and said that they were "very approachable."

Staff told us there was always a sufficient supply of gloves, aprons, hand wash, gels and other items required to ensure good standards of care. They told us that they had attended training in the decontamination of equipment and infection control. Staff said they felt confident with the procedures and said that there was additional guidance to follow if needed. Staff were able to show us the decontamination process and describe how the equipment was monitored to ensure it was working efficiently.