We carried out this announced inspection on 08 May 2019 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

Albion Dental is in Lewes, East Sussex and provides NHS and private treatment to patients of all ages.

The practice is accessed via external steps and situated on two floors. Parking spaces for blue badge holders are located close to the practice.

The dental team includes the principal dentist, two associate dentists, one dental hygienist/therapist, two dental nurses, two receptionists and an assistant practice manager who is also a dental nurse. The practice has four 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 collected feedback about the practice from 14 patients.

During the inspection we spoke with the principal dentist, one dental nurse, two receptionists and the assistant practice manager. Additionally, we spoke with the consultant practice manager for the provider. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Thursday 8.30am to 5.30pm
• Friday 8.30am to 5pm

Our key findings were:

• 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 provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

There were areas the practice could make improvements and should:

• Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective.

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare Products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• Review the practice’s protocols to ensure audits 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.
• Review the practice’s protocols and procedures in relation to the Accessible Information Standard to ensure that that the requirements are complied with.

• Review the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.

During our inspection visit we spoke with three people using the service who stated that their treatments had been discussed with them by practitioners in private. They said that details about their treatment had been clearly explained to them before any treatment was undertaken. This had been supported with treatment plans and details of any associated costs before care took place. The people we spoke with confirmed that they had been given time to consider the options presented to them between appointments.

One person told us how particularly considerate the practice was in managing her painful joints when she was undergoing treatment. She said that everyone in the practice was pleasant, helpful and considerate.

Staff were reported as being knowledgeable, helpful and receptive if there were any further queries or concerns.