We carried out this announced inspection on 4 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 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

A R Fee Dental Practice is near the centre of Burslem and provides NHS and private dental care for adults and children.

The provider has installed a ramp to facilitate access to the practice for wheelchair users. Car parking is available near the practice.

The dental team includes a dentist, a dental hygiene therapist, a dental hygienist, and three dental nurses. The dental team is supported by a practice manager. 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.

We received feedback from 57 people during the inspection about the services provided. The feedback provided was positive.

During the inspection we spoke to the dentist, 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:

Monday to Friday 8.00am to 4.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
• The provider had staff recruitment procedures in place. References and employment histories were requested for employed staff but not routinely requested for clinicians.
• Staff provided patients’ care and treatment in line with current guidelines.
• The dental team provided preventive care and supported patients to achieve better oral health.
• The dental hygienist ran clinics providing oral health education and monitoring of oral health for children who were patients of the practice and for those who had been referred to the practice for orthodontic assessment, to reduce their risk of dental disease.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took account of patients’ needs.
• The provider had a procedure in place for dealing with complaints. The practice dealt with complaints positively and efficiently.
• The practice had a leadership and management structure and a culture of continuous improvement.
• The provider had systems in place to manage risk.
• Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.

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

• Review the practice's recruitment procedures to ensure that appropriate checks, including references and employment history, are completed prior to new staff commencing employment at the practice, and to ensure complete records are maintained for all staff.
• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, review the fire risk assessment in conjunction with suitable fire safety advice in order to establish whether further reasonably practicable measures to reduce risk could be put in place.

We carried out this inspection to check on the care and welfare of people who used this service. Our inspection was discussed and arranged two days in advance. This was to ensure that we had time to see and speak to staff working at the practice, as well as people registered with the service. We checked the NHS Choices website prior to our inspection.

The practice provided dental care and treatment to both private and NHS patients.

People who used the service told us they were treated with respect and fully involved in discussions about and planning for their treatment. People could consider their treatment options and did not have to make a decision immediately.

We spoke with two children who attended with their father and three adults who used the service. They were all complimentary about the treatment and support they received. One person said, "The dentist is very gentle, and everything is explained as he goes along".

There was a high standard of cleanliness. One person who had received treatment said, “Everything is always spotless”.

Staff told us they liked working at A R Fee dental practice and they felt supported in their work.

Accurate records were maintained about the people who used the service and regarding the running and maintenance of the service.