We carried out this announced inspection on 8 May 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Valley Drive Dental Practice is in Gravesend and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes six dentists, five dental nurses, three trainee dental nurses, a practice manager, an assistant manager and an administrator who is also a registered dental nurse. The practice has five treatment rooms.

The practice is owned by a partnership 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 Valley Dental Practice was the principal dentist.

On the day of inspection we collected 31 CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with three dentists, three dental nurses, the administrator and the assistant practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Friday 9.00am – 1.00pm & 2.00pm – 5.30pm.
• Saturdays 08.30am – 1.00pm.

Our key findings were:

• The practice appeared clean and well maintained. However we did note that some areas were cluttered.
• 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.
• 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.
• The practice had effective leadership and culture of continuous improvement.
• 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.
• The practice had suitable information governance arrangements.

There were areas where the provider could make improvements. They should: Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used,

in particular by decluttering areas throughout the practice

We spoke to two patients who were very satisfied by the care they had received making comments such as "Always very helpful, fitted me in quickly without a long wait" and "First class service".

Through review of the medical records and discussion with staff we found that patient’s needs were assessed and care and treatment planned and delivered in line with their plans.

We observed the cleaning procedures in operation between patients and saw how contaminated areas were cleaned. The nurse described a check list which was followed at the beginning of each day and how water lines were flushed between patients. A written log was shown which describes how this was recorded for each surgery demonstrating that there were effective systems in place to reduce the risk and spread of infection.

Staff received appropriate professional development. There are three qualified nurses who were registered with the General Dental Council and two trainee nurses. Each staff member was responsible for updating their individual records of training and ensuring they have completed the required continuing professional development.

Patient’s records were accurate and fit for purpose. We saw that they were complete with medical histories and treatment plans.