We carried out this announced inspection on 9 November 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

Rainbird House Dental Practice is in Brentwood, Essex and provides private treatment to adults and children.

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

The dental team includes one dentist, three dental nurses one of whom is the practice manager. The practice has one treatment room.

The practice is owned by a Limited 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 Rainbird House Dental Practice is the principal dentist.

On the day of inspection, we collected 23 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist, two dental nurses, 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 Thursday from 9.30am to 5.30pm. The practice is not open for appointments on Friday. Saturdays by appointment.

Our key findings were:

• Strong and effective leadership and culture of continuous improvement was provided by the management team which included the principal dentist and the practice manager. Staff felt involved and supported and informed us this was a good place to work.
• The practice appeared clean and well maintained. Cleaning schedules were in place and the standard of cleaning was audited monthly by the practice team.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were mostly available. We noted that one medicine used to treat a number of conditions including seizures was not available. We discussed this with the dentist who confirmed this would be put in place.
• The practice had systems to help them manage risk. There were no systems in place to monitor fridge temperatures to ensure any medicines stored in them were maintained at the correct temperatures. We discussed this with the dentist who confirmed these would be put in place.
• The practice staff 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.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided. Results of feedback were analysed and discussed at staff meetings to share learning.
• The practice staff had suitable information governance arrangements.

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

• Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
• Review the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.