We carried out this announced inspection on 01 November 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 who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information 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 Practice is in Ulverson south Cumbria and provides private dental treatment to both adults and children.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available at the practice.

The dental team includes one dentist, three dental nurses (of which one is a trainee dental nurse) and one part-time dental hygienist. The practice has three treatment rooms which are on the ground floor of the building.

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 43 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday – Wednesday 9.00am – 5.15pm

Thursday 9.00am – 6.00pm

Friday 9.00am – 3.45pm.

Our key findings were:

• The practice was 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.
• Staff were not confident in implementing the Mental Capacity Act 2005 or obtaining consent.
• There were limited procedures for staff development.
• 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 had effective leadership. 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 dealt with complaints positively and efficiently.

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

• Review the practice’s systems in place for environmental cleaning taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• Review its responsibilities as regards the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date and staff understand how to minimise risks associated with the use and handling of these substances.
• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.

We spoke to people while they were in the reception area. They all said they saw the dentist regularly and felt the care they received was excellent.

People confirmed that the dentist always explained what was happening, what they had found during examination and what the treatment options were. They confirmed they had received information to enable them to decide upon treatment options. People we spoke to were also knowledgeable about the cost of the treatments and had been given information about the payment plans the service offered.

They spoke highly of the staff and their caring attitude especially if they felt nervous or apprehensive.

Comments we received included,

“I was terrified when I first started coming but I feel much better now. Andy and all the staff are great”.

“My husband and I have been coming to The Practice for some years now and we are more than happy. It is great now because we don’t have a job finding a parking space”.