We carried out this announced inspection on 15 August 2017 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

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

Ashby and Atkinson Dental Practice - Main Street is in Shildon, County Durham and provides NHS and private treatment to adults and children.

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

The dental team includes two principal dentists, two associate dentists, a foundation training dentist, the practice manager, a dental hygienist and eight dental nurses who also perform reception duties. The practice has four treatment rooms.

The practice is owned by a partnership 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. The registered manager at Ashby and Atkinson Dental Practice - Main Street was one of the principal dentists.

On the day of inspection we collected 36 CQC comment cards filled in by patients and spoke with one other patient. This information gave us an exceedingly positive view of the practice.

During the inspection we spoke with three dentists, six dental nurses / receptionists, the dental hygienist 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 and Wednesday  8.45am - 6.00pm

Tuesday and Thursday 8.45am - 5.00pm

 Friday 8.45 until 5.30pm

Saturday once per month 8.45 until noon.

Our key findings were:

• The practice was clean and well maintained.
• 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 practice 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.
• The appointment system met patients’ needs.
• The practice had effective leadership. 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 dealt with complaints positively and efficiently.

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

• Review the practice's policy and procedures to ensure they are in compliance with the Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken for materials held on-site.

People that used the practice told us that they were happy with the service provided. They felt they were given enough information about their treatment options and the relevant fees and were able to ask all the questions they wanted to. They found the staff to be friendly and reported that they were treated with respect and their privacy was maintained.

People told us that "The reception staff are excellent and they will always fit you in" and "I never have to wait, I am always told what treatment options I can have.”

One person told us, “I have had to have lots of dental treatment following an accident. The dentist did a great job to repair my teeth. I am more than satisfied with the service I have received, and they are also great with my children.”

The Practice manager and the dentist said the practice ensured national and local guidance about safeguarding people from abuse were accessible to all staff. They ensured that all staff were trained and understood all aspects of the safeguarding processes.

The practice manager told us all staff had attended training in the decontamination of equipment and infection control. There was additional guidance to follow if needed. The practice manager and the dentist were able to show us the decontamination process and described how the equipment was monitored to ensure it was working efficiently.

The Practice manager said that there were detailed policies and procedures in place for the safe use of emergency medication. She said that all staff were aware of these and that they had been trained to use emergency dental equipment. She explained all patients were asked about known allergies including previous reactions to local anaesthetics, antibiotics and latex etc.

Staff spoken with told us that they were very happy working at the practice and that most of the staff had worked there for a number of years. Staff said that there was a "good team" and that they supported one another.

The practice manager and the dentist clearly explained the systems that the practice had in place to check quality and to manage risk.