We carried out this announced inspection on 10 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 providing well-led care in accordance with the relevant regulations.

Background

Wycherleys Dental Practice is in Newport, Shropshire and provides private treatment to adults and children.

A portable ramp is available to gain access to the front of the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes three dentists, six dental nurses, four of whom are trainees and two of whom also cover reception duties, one dental hygienist, one dental hygiene therapist and a practice manager. The practice has two treatment rooms.

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 Wycherleys Dental practice is the principal dentist. A registered manager is legally responsible for the delivery of services for which the practice is registered.

On the day of inspection we received feedback from three patients.

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

The practice is open:

Our key findings were:

• The practice appeared clean and well maintained. Patients confirmed that this was always the case.
• The provider had infection control procedures which reflected published guidance. Infection prevention and control audits were completed annually and not on a six-monthly basis as recommended.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available and systems were in place to ensure they were all in date and available for use.
• The practice had systems to help them manage risk to patients and staff. Risk assessments were reviewed and updated as necessary, on at least an annual basis.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Staff recruitment procedures required improvement. The practice manager confirmed that they had introduced new recruitment policies and 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs. Extended opening hours were available until 7.45pm on a Monday and the practice was open on a Saturday.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team. Staff said that they were proud to work at the practice.
• The provider asked staff and patients for feedback about the services they provided. Patients had written testimonials which were available on the practice website.
• The provider had systems in place to deal with complaints positively and efficiently. Staff were aware of duty of candour requirements to be open and honest.
• The provider 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 ensuring that gas safety checks are completed and a gas safety certificate provided.

• Review the practice’s protocols to ensure audits of radiography and infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.