We carried out this announced inspection on 24 July 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

Amber Valley Dental Practice is located in Swanick near Alfreton in North Derbyshire and provides NHS and private dental treatment to adults and children.

The practice is situated on the ground floor and there is level access into the practice. This is of benefit for people who use wheelchairs and those with pushchairs. There is roadside car parking outside the practice.

The dental team includes four dentists, one qualified dental nurse, two trainee dental nurses, one receptionist and one practice manager. The practice manager is also a qualified dental nurse. The practice has three ground floor 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. At the time of the inspection the practice did not have a registered manager. The newly appointed practice manager was in the process of applying to be the registered manager.

On the day of inspection, we received feedback from 21 patients.

During the inspection we spoke with two dentists, two dental nurses, one receptionist and three managers representing the provider. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday: 8.30am to 5:30pm. The practice is closed on Saturday and Sunday.

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Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• Not every product had a COSHH risk assessment to accompany the relevant product safety data sheet.
• 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.

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

• ‘Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken for all relevant dental materials and substances.’

We spoke with two patients who had come for appointments. They were both NHS patients and were mostly happy with the treatment they had received. All of the patients felt that the dentist they had seen that day had explained their treatment and that they received sufficient information before treatment began.

Patients’ needs were assessed and that they were asked to complete a medical history questionnaire before being seen in the surgery. This information was then reviewed with the patients at subsequent visits.

We found that patients had raised concerns about the waiting time for appointments and the turnover of dentists working at the practice. The provider was taking steps to improve the service which included recruiting an additional full time dentist to the practice.

During our inspection we noted that a number of audits were taking place. We observed that issues highlighted during the audits were not being followed up appropriately. This meant that there was an ineffective system in place to monitor the quality of the service being provided.