We carried out this announced inspection on 20 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

Lawley Dental Practice is in Telford and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including four for blue badge holders, are available near the practice.

The dental team includes three dentists, seven dental nurses, one dental hygienist, one practice manager and one assistant practice manager. The dental nurses and managers also carry out reception duties. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist 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 44 CQC comment cards filled in by patients.

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

The practice is open:

Monday – Friday between 9am and 5:15pm.

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. One medicine was not available in the recommended form of administration. This was promptly ordered once we brought it to the attention of staff.
• 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.
• The provider had thorough staff recruitment procedures with the exception of one staff member who did not have their complete immunisation records available.
• 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.
• The appointment system took account of patients’ needs.
• 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.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• 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.

People told us that they were happy with the service provided and that their dignity was maintained and their privacy protected. They were encouraged to ask questions and felt staff had the time to answer their questions. People reported that staff were good at discussing all their treatment options with them. One person told us, "I've had a lot of treatment and everything is fine, they fit me in quickly and always explain any treatment I need as well as the cost". Another person told us, "All staff are really helpful, I'm always informed about the treatment I receive. It's always very clean here".

Overall we found that the provider was operating effective systems to ensure patients received appropriate care and treatment in an environment which was clean. We found that services were provided by staff that were appropriately supported in relation to their responsibilities.