We carried out this announced inspection on 05 October 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 NHS England 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 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 Gallery Dental Practice is located in Cuckfield. It provides NHS and private treatment to patients of all ages.

The practice is located on two floors. There are three treatment rooms including a wheelchair accessible treatment room on the ground floor and a decontamination room. There is a separate reception area and two patient waiting rooms, one on either floor.

The dental team includes the principal dentist, two associate dentists, one hygienist, three qualified dental nurses, and one trainee dental nurse. All dental nurses perform a dual role as receptionist.

The practice is owned by an individual who is the principal dentist. 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.

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

We spoke with seven patients who gave us a positive view of the practice.

The practice is open: Monday to Thursday from 9am to 5pm and Friday from 8am to 2pm.

Our key findings were:

• The practice appeared 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.

During our inspection we spoke with patients in the waiting area of the practice. All of the patients we spoke with were positive about their experience of using this dental practice. They told us that they found the staff to be "Friendly and approachable.” Another patient said “I could not be more pleased with the treatment.”

We saw that patient's views were taken into account in the way the service was provided and delivered. For example, one patient told us that they had discussed treatment options with the dentist and could opt for treatment under the National Health Service (NHS) or privately. One patient told us “It’s a really good dental practice.”

We found that the practice maintained patient records which included up to date medical histories, medical alerts and treatment plans. Staff told us that the dentist would verbally check the medical history at each treatment visit. The records demonstrated that dentists got consent from patients before they started any treatment.

We saw that the premises were visibly clean and tidy. Staff spoke knowledgeably about decontamination and sterilisation processes they used. One patient we spoke with said "The practice is always clean and tidy.”

The provider did not have adequate arrangements in place to deal with foreseeable emergencies within the practice. We saw evidence that equipment was routinely serviced and maintained. However, the provider was unable to demonstrate that the portable emergency oxygen bottles had been regularly checked to ensure that they would operate correctly when necessary. Additionally, the emergency drugs box contained out of date drugs. This meant that patients who used the service were potentially at risk of not receiving appropriate care and treatment in an emergency situation.

We saw documentation which confirmed that all relevant staff employed by the service held current registrations with their professional body the General Dental Council (GDC).

We also saw documents which confirmed that the practice held checks with the Disclosure and Barring Service (DBS) for all relevant staff. This meant that the service had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.