We carried out this announced inspection on 24 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 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 Raglan Suite is in Harrogate, North Yorkshire and provides private treatment on a referral basis.

There is a permanent ramp for people who use wheelchairs and have pushchairs. Car parking spaces, including parking for patients with disabled badges, are available near the practice.

The dental team includes 8 directors amongst who are dentists who are specialists or have special interests in dental implant dentists, periodontology, sedation service, endodontics, facial aesthetics, clinical dental technician and one covers the financial arrangements. There is a Specialist Orthodontist, two GPs who provide dermatology services, a Specialist Paediatric dentist, a dental hygienist therapist, three treatment co-ordinators, eight dental nurses (two of which are also treatment co-ordinators), a sterilisation technician, a practice manager, a business manager, a reception manager, and two receptionists. The practice has five dental treatment rooms and a dermatology suite.

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 Raglan Suite was the practice manager.

On the day of the inspection we collected 35 CQC comment cards filled in by patients. This information gave us a very positive and caring view of the practice.

During the inspection we spoke with three dentists, three dental nurses (two of which were treatment co-ordinators), two receptionists, the clinical dental technician, the sterilisation technician and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Wednesday, Thursday and Friday: 9am to 5:30pm

Tuesday: 9am to 6pm.

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 respond to 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 had effective leadership. Staff felt involved, 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.

To help us understand the experiences of people using the service, we spoke with people who had attended the surgery at the time of our inspection.

We spoke with people in private at the practice address. Everyone we spoke with said that they were treated with dignity and respect. They said they signed to say they agreed with the treatment and that they had their treatment options explained to them. People told us they were supported to make decisions and choices regarding their care and treatment. One person said “I would recommend this surgery to anyone” another said “They have exceeded my expectations and I am very happy with the treatment I have received.”

People told us that there were no difficulties in obtaining prompt appointments and appointments were not delayed and they also commented that they thought the surgery and practice building were always clean when they visited.

We spoke with one of the five dental nurses and they told us they were well supported in their role and this included ensuring they were up to date in their clinical practice.

The practice had systems in place to monitor the quality of the service, which also included seeking feedback from people who used the service.