We carried out this announced inspection on 27 November 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Apex Dental Practice is in Somerton and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available on the street near the practice.

The dental team includes four dentists, six dental nurses and a trainee dental nurse, two dental hygienists, three receptionists and a practice manager. The practice has four treatment rooms.

The practice is owned by an individual who is the principal dentist. 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 16 CQC comment cards filled in by patients and spoke with two other patients.

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

The practice is open:

• Monday – Friday 09.00am – 5.00pm

• Closed at weekends.
• Emergency treatments - We offer emergency cover usually available on the day of contact for our patients from Monday to Friday. If the practice is closed please contact the Somerset Dental Advice line on 0300 1237691 or the NHS Direct Advice Line on 111.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• The provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a 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 provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review stocks of dental products and the practice system for identifying, disposing and replenishing of out-of-date stock.
• Review the practice recruitment procedures to ensure that a risk assessment is completed for staff commencing work before a Disclosure and Barring Service check is completed.

We spoke with four people who attended the practice. One person told us they would definitely recommend the practice to anyone with a child who was nervous as the dentist had been “very kind” to their child. They told us their whole family now attended the practice and said the dentist “always gives the best treatments, good explanations and ensures they understand”.

Information was made available to people and they were involved in making decisions about their treatment. Good records were maintained about the treatment provided and there were arrangements in place to deal with medical emergencies. Staff received training opportunities and were aware of arrangements should they have cause for concern about a child or vulnerable adult.

The premises were suitable and accessible and there were arrangements in place to control the risk of infection.

The staff in the practice felt supported and there were sufficient staff for the running of the service. The provider had systems in place so that staff were appropriately checked before they were appointed.

The provider had a range of systems to monitor the quality of the service provided including asking people who used the service for their views. The service responded appropriately to any complaints received.

We looked at the NHS Choices website where there was the facility for people to comment on services providing NHS subsidised treatments. There were no comments posted on the website for this practice.