We carried out this announced inspection on 20 April 2017 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 with remote access to a specialist dental adviser.

We told the NHS England Cheshire and Merseyside area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

The Edge Dental Practice is close to the centre of Alderley Edge and provides treatment to patients of all ages on a privately funded basis.

There are steps at the front entrance to the practice with a handrail positioned alongside to assist patients with limited mobility. The provider has a portable ramp available to facilitate access to the practice for wheelchair users. Car parking is available near the practice.

The dental team includes three dentists, a dental hygienist / therapist and five dental nurses, one of whom is the office manager and receptionist. The practice has three treatment rooms.

The practice is owned by a partnership and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 The Edge Dental Practice was one of the partners.

We received feedback from 18 people during the inspection about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to two dentists, one dental nurse and the office manager. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open: Monday and Wednesday 9.00am to 6.00pm, Tuesday and Thursday 8.00am to 5.00pm, Friday 9.00am to 3.00pm and Saturday 9.00am to 1.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• The practice had systems to help them manage risk.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.

• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.

• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had staff recruitment procedures in place. We found these needed minor improvements.

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

• Review the protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes ensuring recruitment checks, including references, are carried out and recorded for all staff.
• Review the practice’s protocols for conscious sedation, taking into account the 2015 guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.
• Review the protocols and procedures to ensure staff are up to date with their training and continuing professional development.

The Edge Dental Practice was a wholly private dental practice. The provider had recently relocated to different premises, absorbing the former dental practice based at this location into their practice. One patient commented on the recent changes in that their dental practice had relocated saying: “Regardless of where the dental practice is located this is the best dentist I have ever had, I would go no-where else.”

We spoke with four patients who were visiting the practice during our inspection they all told us they were happy with the service provided. One patient told us: “The staff are all friendly and very helpful.” Another patient told us: “The practice is excellent and that’s the reason I return, I can’t praise them enough.”

People told us that the dental practice was well presented and that the surgeries were always very clean and tidy when they attended.

Two of the patients who had attended the practice told us they had received dental treatment. They told us they were consulted and informed about the treatment options, had consented to the treatment provided and were given appropriate after care advice following any treatment. They said they were happy with their dentist and the practice. They told us they found the staff to be professional in their approach.