We carried out this announced inspection on 7 September 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 the NHS England area team and Healthwatch that we were inspecting the practice. NHS England supplied us with contractual 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

Golds Place Dental Practice is in Cullompton and provides mostly private treatment to patients of all ages. The practice also holds a small NHS contract.

The practice is located on the first floor, accessed by stairs. Therefore patients need to be able to manage one flight of stairs to access the practice. Car parking spaces are available near the practice.

The dental team consists of one dentist and one dental nurse/receptionist. The practice has one treatment room.

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 Golds Place Dental Practice was the dentist.

On the day of inspection we received feedback from 49 people. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist and dental nurse/receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Mondays and Tuesdays 9am – 5pm. Thursdays and Fridays 9am – 5pm. The practice also opens on two Saturdays per month 9am – 12pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures.
• 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.

There were areas where the provider could make improvements. They should:

• Review the practice protocols and procedures for the use of rectangular collimation, taking into account the 2001 Department of Health ‘Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment’.
• Review the practices’ infection control procedures, taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular with regard to date stamping sterilised pouched instruments and completion of start-up checks for autoclaves.
• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.

This was our second inspection of Gold’s Place dental practice during 2012. We had inspected the practice in March 2012 and found that people were satisfied with the advice given by the dentist and the treatment they received. However, we asked for improvements to be made with respect to storage of paper records to improve patient confidentiality, staff training to improve their knowledge when acting to protect vulnerable adults and the management of infection control.

The provider sent us an improvement action plan. We visited the practice on 11 September 2012 and found that the improvements we asked for were met. We also contacted a selection of people who had attended the practice for check ups or treatment the day of our visit or the day preceding our visit. We heard comments from 12 people who had either received treatment themselves or who represented children who had received treatment at Gold’s Place. We found that the high levels of patient satisfaction with the practice in the March inspection had been sustained. Comments included;

• ‘The dentist is very gentle, very caring.’

• ‘I know the signs to use – if anything hurts during treatment you just put your hand up and she stops.’

• ‘I am very satisfied.’

• ‘I was given a range of options for treatment to consider for my new dentures.’

• ‘The dentist is very personable.’

People who used the service told us they were happy with the treatment provided at Golds Place Dental Practice. They said they received treatment that was explained clearly by the dentist. People told us staff were always helpful, friendly and polite. One person we spoke with told us they were previously “petrified” of visiting the dentist. They said that since they have attended this practice they have found the practice to be “professional” that provides a “personal experience” to them and their family. They said “I always get to see the same people” which they said enabled them to feel more relaxed and they knew what to expect when they visited.

We observed a person who received treatment by the dentist at Golds Place Dental Practice. We observed how the dentist and dental nurse interacted with the person. The dentist gave clear explanations of the treatment provided and why it was necessary. It was clear that the dentist knew the person well and their previous history. The dentist and dental nurse were respectful and the person appeared relaxed whilst they received their treatment.