We carried out an announced comprehensive inspection on 3 August 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

West Country Dental & Implant Centre is located in the coastal town on Barnstaple, Devon. The practice provides primary dental care services for people who require dental procedures. The practice provides NHS and private patient care. There are eight dental surgeries (four situated on the ground floor and four on the first floor). There is level access from the street. Approximately 9,600 patients are registered at the practice. The majority of patients are adults.

The staff structure of the practice consists of nine dentists and a dental hygienist. There is a practice manager, deputy practice manager and nine dental nurses. Dental nurses also act as reception staff. The practice is also a training practice for dentists in their foundation years after graduating.

The practice is open from Monday to Saturday from 8.45am to 5.15pm (with extended opening until 6.30pm on Wednesdays). There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 inspection took place over one day and was carried out by a CQC inspector.

Thirty five patients provided feedback directly to CQC about the service. All thirty five patients were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• There were effective systems in place to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment text/phone reminders were available on request 48 hours prior to appointments.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke to felt supported by the management team and were committed to providing a quality service to their patients.

We carried out a routine inspection of Westcountry Dental & implant Centre on 16 January 2014. We looked at the records of four patients and spoke with them at length during their appointment. We spoke with another eight patients in the waiting room or over the phone after their appointment. We spoke with nine staff in total, which included receptionists, dentists, dental nurses and managers.

We asked NHS England (Devon, Cornwall and Isles of Scilly) for their comments because they have a monitoring role in the commissioning of NHS dental care at this practice. NHS England reported there were no concerns with this practice.

Patients made positive comments about their experience of treatment at the dental practice. We were told the practice was very responsive when patients were in pain and needed emergency treatment. For example, a patient said “They’re always very good if I need an emergency appointment or even a routine one”. The patients we spoke with described staff as being “friendly”, “reassuring” and were “impressed” by the way they looked after them.

We followed four patient’s appointments from start to finish and all said they had been comfortable, one said, “I had a filling but didn’t feel a thing and didn’t even need a local anaesthetic”. Information about fees and treatment plans was discussed with patients, for example, one patient said “I was initially given a list of prices and told what I needed to have done”. Another person told us “The dentist was quite clear with me about what was needed. I decided not to go ahead, but if I need to have the treatment I know exactly what will happen because it’s been explained”.

The practice had systems in place which meant patients were safe and well cared for. Patients described the environment and equipment used as being “spotless” and “bright and airy”. We saw decontamination and cleaning procedures followed national guidelines, which meant equipment was safe to use on patients.

The provider was compliant with all five outcomes we looked at.