We carried out this announced inspection on 22 May 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

St Martins Dental Practice is in Hereford and provides private treatment to adults and children.

There is a large ramp to the side of the building which provides access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available near the practice.

The dental team includes seven dentists, nine dental nurses, two dental hygiene therapists, two receptionists, a deputy manager and a practice manager. The practice has seven treatment rooms.

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 St Martins Dental Practice was the practice manager.

On the day of inspection we collected 45 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, two dental nurses, one dental hygiene therapist, two receptionists, the compliance facilitator and the deputy manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday: from 9am to 5.30pm

Tuesday: from 8am to 7.30pm

Wednesday: from 8am to 7.30pm

Thursday: from 8am to 5.30pm

Friday: from 8am to 5.30pm

Our key findings were:

• Effective leadership was provided by the practice manager and deputy practice manager.
• Staff we spoke with felt well supported by both the practice manager and deputy practice manager and were committed to providing a quality service to their patients.
• The practice appeared clean and well maintained. An external company was contracted to provide this service and cleaning schedules were maintained to monitor this.
• 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. There was a process in place for the reporting and shared learning when significant events occurred in the practice.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Safeguarding contact details were displayed in the practice manager’s office and the staff room. Both the practice manager and deputy practice manager had completed a designated safeguarding officer course.
• 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. Patients could access routine treatment and urgent care when required.
• Due to being part of a corporate organisation the practice was supported further by staff based at their head office ‘The Port’.
• The practice asked staff and patients for feedback about the services they provided. Results of these audits were analysed and action plans implemented.
• The practice staff dealt with complaints positively and efficiently. Additional support was available from the group’s internal complaints lead.
• The practice staff had suitable information governance arrangements.

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

• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken for all relevant dental materials and substances.

We spoke with six people who used the service. They were all extremely complimentary about the staff and the service they received. One person told us that the service was, “Great”. Another person said that it was, “Really very good”. People told us that it was easy to get appointments at the practice.

We saw that people were involved in discussions about their treatment and that their views were listened to. People told us they were given the appropriate information about their treatment needs. They told us the dentists always discussed treatment options with them. We saw evidence of this in people’s treatment records.

People received their treatment in a clean, hygienic environment. The practice had suitable arrangements in place to ensure people were not placed at risk of cross infection. Staff told us they were provided with good opportunities to further develop their skills and knowledge and to meet the requirement of their professional registration.

The practice had an appropriate complaints policy. A summary of the policy was available in the reception area and waiting rooms. Although not everyone we spoke with was aware of how to complain, they told us they were confident any concerns raised would be listened to and addressed.