We carried out this announced inspection on 12 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

There is ramp access for people who use wheelchairs and those with pushchairs. Car parking spaces are available at the rear of the practice.

The dental team includes the principal dentist and an associate dentist, four dental nurses (one of whom is a trainee) and the practice manager. The practice has two 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 19 CQC comment cards filled in by patients.

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

The practice is open:

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.
• The practice had systems to help them manage risk to patients and staff.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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 provider 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 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 monitoring and recording the fridge temperature to ensure that medicines are being stored in line with the manufacturer’s guidance. In addition, review the process to ensure weekly checks are carried out in line with published guidelines.
• Review the contents of the radiation protection file and ensure the critical examination documents are in place. In addition: review and address any recommended actions on the critical examination document.
• Review the practice’s sharps risk assessment to ensure it reflects practice procedures and is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the practice’s website and practice information leaflet to ensure details are available for patients to make a complaint.

We asked 6 patients for their views on the dental services they received. All were very complimentary and very positive about the attitude and approach of the staff at the surgery. We received numerous comments about the standard of care and treatment given which included, "everything is fully explained, I am very, very happy with everything about the service".

Another person told us that the service was "professional and extremely understanding of nervous patients".

People told us that they felt confident that both the dentist and support staff were experienced and trained. Comments included "the staff are friendly, smart and re-assuring" and "I was given full information and everything was explained to me in a clear way".