We carried out this announced inspection on 7 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

Andrew Brown Dental Surgeon is a well-established practice that provides mostly private treatment to approximately 1300 patients. It has a small NHS contract to provide dental care to children and exempt adults. The dental team includes one dentist, two dental nurses, a practice manager and visiting hygienist. There are two treatment rooms.

The practice opens on Mondays and Tuesdays from 8.30 am to 6 pm; on Wednesdays and Thursdays from 8.30 am to 5 pm, and on Fridays from 8.30 am to 1.30 pm.

There is level access for people who use wheelchairs and those with pushchairs. There are a few parking spaces available directly outside the practice.

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.

On the day of inspection, we collected 57 CQC comment cards filled in by patients and spoke with two other patients. We spoke with the dentist, the practice manager, and two nurses

We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• Information from completed Care Quality Commission comment cards gave us a positive picture of an effective, caring and professional service.

• The practice appeared clean and well maintained and infection control procedures 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 to patients and staff.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.

• The practice took patients’ complaints seriously and responded to them appropriately to improve the quality of care.

• Patients received their care and treatment from well supported staff, who enjoyed their work.

• The provider asked staff and patients for feedback about the services they provided.

There were areas where the provider could make improvements and should:

• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to staff commencing employment at the practice.

• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

• Review current policies and procedures for recording patients’ informed consent to care and treatment and ensure they reflect current legislation and guidance.