We carried out this announced inspection on 25 June 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

Ashwell Dental Surgery is in Ashwell, Baldock 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 near the practice.

The dental team includes four dentists, a visiting specialist/oral surgeon, two dental nurses, two dental hygienists, one receptionist and a practice manager. 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 Ashwell Dental Surgery was the principal dentist.

On the day of the inspection we collected 19 CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with three dentists, the visiting specialist oral surgeon, one dental nurse, one receptionist who worked across the company practices and the company area manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday from 8.30am to 1pm and 2pm to 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 mostly available with the exception of one size four airway which we were told was immediately ordered.
• 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 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.

During our inspection on 23 May 2013, we received positive comments about the service from the people we spoke with. We spoke with three people who told us they were satisfied with the care and treatment they received from their dentist; that they always saw the same dentist each time they visited the practice; and they could get appointment times that suited them.

People we spoke with told us they had been spoken to politely by reception and dental staff whenever they attended the practice. Two people we spoke with said that they would recommend the service.

We found that dental staff had explained the treatment options to people at the beginning of their consultation and that they had been involved in decisions about their oral healthcare. Care records showed people had been given comprehensive dental plans which clearly outlined their treatment and any associated risks.

We spoke with all dental staff on duty on the day of our visit, including the receptionist, dental nurses, the hygienist and dentists. All the staff we spoke with said that they felt well supported to do their job and that they received the training they needed.

We found suitable and appropriate infection control processes were in place to ensure people were not exposed to the risks of cross infection and that the appropriate published guidelines had been followed.