We carried out this announced inspection on 2 August 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

The Old Dispensary Dental Surgery is in Dawlish and provides NHS and 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 three dentists, one dental hygienist, two dental nurses, two dental nurses/receptionists, one trainee dental nurse and one receptionist. The practice has three 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 The Old Dispensary Dental Surgery was the principal dentist.

On the day of inspection we collected 50 CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with one dentist, one dental hygienist, two dental nurses, one dental nurse/receptionist and one trainee dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9am – 1pm. 2pm – 5:15pm.

Our key findings were:

• The practice appeared clean and well maintained.
• Staff knew how to deal with emergencies.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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.
• The practice had not received any complaints.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s system in place for cleaning and sterilising dental instruments in treatment rooms, taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

• Review the suitability of the equipment used for the development of X-rays.

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

We spoke with six patients. All these patients were happy overall with the treatment they had received. Where appropriate they had been given treatment options and the information they needed to be able to make their choice. They felt that their decisions and opinions were respected by the staff.

We found that patients were given appropriate information about their treatment. Information was collected and updated about patient's medical conditions to ensure patients remained safe when being treated. Equipment was available and staff trained to deal with medical emergencies.

Patients were cared for in a clean, hygienic environment.

There was a commitment on the part of the provider to staff training and development and by all staff themselves to remaining appropriately trained and to enhance their knowledge and skills.

Patient records were compiled and maintained adequately and stored and, where appropriate, destroyed securely