We carried out this announced inspection on 16 May 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

Toddington Dental Surgery is in the village of Toddington near to Dunstable in Bedfordshire and provides NHS and private treatment to patients of all ages.

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

The dental team includes three dentists, three trainee dental nurses, one dental hygienist and a practice manager who is also a qualified dental nurse. The practice has three treatment rooms.

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

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

The practice is open from 8 am to 5 pm on Monday, Tuesday, Wednesday and Friday and from 10 am to 6 pm on a Thursday.

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.

• The practice had thorough staff recruitment procedures; however they did not document verbal references.

• 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.

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

• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.

• Review staff training to ensure that all of the staff had undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.

• Review the procedure for ensuring that risks arising to staff from Hepatitis B are adequately mitigated.