We carried out this announced inspection on 17 December 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 not providing well-led care in accordance with the relevant regulations.

Background

Dental Pods is based in Peterborough city centre and provides private dental treatment to about 1300 patients. The dental team includes three part-time dentists, a practice manager, two dental nurses and a receptionist. There are two treatment rooms.

The practice opens on Mondays, Tuesdays, Fridays and Saturdays from 9 am to 5 pm; and on Wednesdays and Thursdays from 9.30 am to 5.30 pm. Car parking spaces, including some for blue badge holders, are available in public car parks near to the practice.

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. One of the directors, who is also the practice manager, is the registered manager for the service.

On the day of inspection, we collected 45 CQC comment cards completed by patients. We spoke with a dentist, the practice manager, one of the directors, a nurse and the receptionist.

We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• Information from completed Care Quality Commission comment cards gave us a positive picture of a caring and professional service. Staff understood the needs of nervous patients.
• Access to appointments was good and the practice opened six days a week, including Saturdays from 9 am to 5 pm.
• The practice appeared clean and well maintained.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Recruitment procedures ensured only suitable staff were employed.
• Patients’ care and treatment was provided in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice proactively sought feedback from staff and patients, which it acted upon.
• There was no system in place to ensure that untoward events were analysed and used as a tool to prevent their reoccurrence.
• The management of risk was limited and potential hazards in relation to fire and the premises had not been identified or assessed to reduce potential harm.
• Staff did not receive regular appraisal of their performance and not all had personal development plans in place.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

There were areas where the provider could make improvements and should:

• Review the practice’s responsibilities to meet the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.