We carried out this announced inspection on 11January 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.

We told NHS England and Healthwatch that we were inspecting the practice. They did not provide any information.

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

Steyning Dental Care is located in Steyning. It provides NHS and private treatment to patients of all ages.

The practice occupies premises on the second floor of Steyning Health Centre. There are three treatment rooms, a decontamination room and a reception area and a separate patient waiting room. The practice holds contracts to provide NHS treatment, minor oral surgery and conscious sedation.

The dental team includes one associate dentist, two locum dentists, one dental hygienist, two dental nurses, one trainee dental nurse, two part time receptionists and a practice manager who performs a dual role as a receptionist.

The practice is owned by a company and is registered with the Care Quality Commission as part of Southern Dental organisation. As a condition of registration they 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 Steyning Dental Care was the practice manager.

During the inspection we spoke with two dentists, one nurse, two receptionists, the practice manager and the regional clinical lead and compliance manager for the company. We looked at practice policies and procedures and other records about how the service is managed.

On the day of inspection we spoke with four patients and collected 19 comments cards that were completed prior to the inspection.

The practice is open: Monday to Thursday from 8.30am to 5.30pm and Friday from 9am 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 appointment system met patients’ needs.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints in an appropriate manner.

We found areas where the provider could make improvements and should:

• Review the practice’s system for documentation of actions taken, and learning shared, in response to incidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography are undertaken at regular intervals to help improve the quality of service. The practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.
• Review the ways in which governance arrangements were overseen and monitored by the company.

During our inspection we spoke with patients in the waiting area of the practice. Most of the patients we spoke with were positive about their experience of using this dental practice. They told us that they had “A good experience today.” Another patient told us that they were able to arrange the appointment when it when suited them (the patient).

We saw that patient’s views were taken into account in the way the service was provided and delivered. For example, one patient told us that they were given treatment options and said “I was involved deciding my treatment.”

We found that the practice maintained patient records which included up to date medical histories, medical alerts and treatment plans. We looked at five patients care records. Staff told us that the dentist would verbally check the medical history at each treatment visit. The records demonstrated that dentist got consent from patients before they started any treatment.

We saw that the premises were visibly clean and tidy. There was hand gel available for patients and visitors at the reception. Staff we spoke with spoke knowledgeably about decontamination and sterilisation processes they used. One patient we spoke with said “This is a very clean and tidy surgery.”

We saw that the practice had appropriate systems in place to manage emergencies. We saw evidence that equipment was routinely serviced and maintained.

We saw documentation which confirmed that all relevant staff employed by the service held current registrations with their professional body the General Dental Council (GDC). We also saw documents which confirmed that the practice held checks with the Disclosure and Barring Service (DBS) for all staff. This meant that the service had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.