We carried out this announced inspection on 25 September 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

Ashley Dental Limited is in Walton On Thames and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. There are limited Car parking spaces near the practice. There is one car parking space outside the practice which can be used for disability parking with notice to the practice.

The dental team includes 3 dentists, 3 dental nurses and 1 trainee dental nurse, 2 dental hygienists, 1 practice manager and 2 receptionists. The practice has 3 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. The registered manager was the principal dentist.

On the day of inspection, we collected 78 CQC comment cards filled in by patients and spoke with 2 other patients.

During the inspection we spoke with 2 dentists, 3 dental nurses, 1 receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Tuesday 07am-07pm

Wednesday 8am–5pm

Thursday 8am–5pm

Friday 8:30am–5pm

Saturday Closed

Sunday Closed

Monday 8am–5pm

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.
• 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.
• 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 where the provider could make improvements. They should:

• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.
• Review the availability of an interpreter service for patients who do not speak English as their first language.
• Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
• Review the practice's waste handling protocols to ensure waste is segregated and disposed of in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01.

We visited Ashley Dental Ltd to look at the care and treatment provided to people who used the service. During our inspection we spoke with four people and one member of staff, the practice manager and the dentist.

People that we spoke with were very happy with the service provided. One person told us “I always trust what the dentist tells me.” Another said “I really like the dentist he’s very patient and kind.”

People told us that the dentist involved them in decisions related to their treatments. One person told us “I’m always given choices regarding my treatments. I are given a treatment plan and can decide which treatment I want.”

People confirmed that the dentist checked their medical histories and medication at each visit to ensure that nothing had changed since the last appointment.

Infection control procedures were followed at the surgery. People told us the practice always looked clean and tidy. One person said “The place is spotless, always very clean.”

The people we spoke with told us they felt safe with the staff.

We saw that records of qualifications, criminal record checks and professional registrations were up to date.

All the people we spoke with told us they knew how to make a complaint but had never made one.