We carried out this announced inspection on 7 June 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 of concern.

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

Family Dental Centre Limited is located in Crawley and provides NHS and private treatment to patients of all ages.

There is access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes two principal dentists and four associate dentists, five dental nurses, one trainee dental nurse, one dental hygienist, six receptionists including a reception manager and a practice manager.

The practice has five treatment rooms over two floors, two decontamination rooms, two X-ray rooms, a reception area and two patient waiting areas; one on each floor. A wheelchair accessible toilet is available.

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 Family Dental Centre Limited was the practice manager.

On the day of inspection we collected 46 CQC comment cards filled in by patients and spoke with six other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses, three 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 to Friday from 8am to 5pm and Saturdays from 9am to 2pm.

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 practice made every effort to accommodate patients with complex needs in respect of accessing the services offered.
• 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.

We identified areas of notable practice:

• In order to help reduce health inequalities, where it was felt a risk that cost would prohibit their use, oral health care products such as toothpaste, toothbrushes and timers were provided free of charge to parents on low incomes to help them assist with improving their child’s oral health.
• Patients with significant physical limitations who were confined to beds and who would otherwise have to be seen in a hospital setting were able to access the practice and receive treatment in a setting that provided more respect to their privacy and dignity. This was due to the commitment of staff to continue treating these patients despite the challenges. Significant efforts were made by the staff in the planning and delivery of these appointments to coordinate with ambulance transportation teams and by utilising enhanced manual handling techniques.

We spoke with five patients during our inspection. We also spoke with the Practice manager, a dentist and four dental nurses. Patients gave positive comments about the Practice. Comments included "I find it quite nice", "I recommend it here", "Very good, I like it" and "Dentist has been really good".

We found that patients were involved in their treatment and understood the treatment options available to them. Patients were treated with courtesy and respect. One patient said "Reception staff are the loveliest people".

Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. Treatment plans were in place where patients required a course of treatment. Patients told us they were happy with the treatment provided.

Patients were protected from the risk of abuse. Staff at the practice were aware of their responsibilities with regard to keeping patients safe and protecting children and adults. There were up to date policies and procedures in place for protecting patients.

We found that patients were protected from the risk of infection because appropriate guidance had been followed. There were appropriate systems in place to maintain standards of hygiene and infection control. All parts of the Practice were clean and tidy.

Staff were supported to deliver care and treatment safely and to an appropriate standard. Training was kept up to date and there were regular meetings to discuss Practice issues.

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