We carried out this announced inspection on 25 April 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

Manor Dental Surgery is in Titchfield Common and provides NHS and private treatment to patients of all ages.

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

The dental team includes three dentists, two dental nurses, one dental hygienist, one practice manager, one administration clerk, one accounts clerk, one cleaner and three receptionists. 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. The registered manager at Manor Dental Surgery was the principal dentist.

On the day of inspection we collected 12 CQC comment cards filled in by patients and spoke with three other patients.

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

The practice is open:

Monday to Thursday 8am to 8pm

Friday 8am to 5pm

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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• 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.
• The practice had suitable information governance arrangements.

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

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’, in particular by increasing the size of the decontamination room to enable the introduction of automated instrument cleaning equipment.
• Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

During our inspection we spoke to the registered provider, two dental nurses, the practice manager, a hygienist, a receptionist and four people who used this service.

People told us they were very happy with the service they received. We were told that the staff fully explained any treatment people were offered and that people were encouraged to ask questions about their treatment. People told us they were given clear information about the cost of different treatments.

We were told that all the staff were very friendly, professional and helpful. People said that appointments were flexible to meet their needs and if they needed urgent dental advice or care that the service was extremely responsive to their needs.

We were told by people who used the service that they felt safe and that the staff made them feel at ease and very welcomed. However one person told us it was difficult to have a rapport with a dentist as they saw a different one each time they visited.

People we spoke with told us that they had no concerns about the cleanliness and hygiene at the service they told us that the premises were always clean and fresh.

We saw that the service had a robust complaints procedure which was available for people to see. Records showed that complaints were dealt with efficiently.

Records showed that a program of audits in place ensured the safety and welfare of people attending this service.