We carried out this announced inspection on 15 January 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

Asquith House Dental Practice is in Lichfield and provides NHS and private general dental treatment to adults and children. In addition to this the practice accepts orthodontic treatment referrals. Orthodontics is a specialist dental service concerned with the alignment of the teeth and jaws to improve the appearance of the face, the teeth and their function. Orthodontic treatment is provided under NHS referral for children except when the problem falls below the accepted eligibility criteria for NHS treatment. Private treatment is available for these patients as well as adults who require orthodontic treatment.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available near the practice.

The dental team includes one dentist with a special interest in orthodontics, three dental nurses (two of whom are trainee dental nurses) one receptionist and two practice managers. The practice has two 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 Asquith House Dental Practice is the principal dentist.

On the day of inspection, we spoke with two patients. In addition to this we viewed patient feedback on NHS Choices, patient satisfaction surveys and friends and family tests.

During the inspection we spoke with the principal dentist, two dental nurses (one of whom is a trainee), and two practice managers. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday from 8.30am to 8pm

Friday from 8.30am to 5pm

Saturday from 9am to 2pm

Our key findings were:

• The provider took over ownership of this practice in 2017 and had made substantial improvements to the premises including renovation to include a ground floor treatment room, wheelchair accessible toilet facilities, a decontamination room and the waiting room / reception had been refurbished and modernised. In addition to this computer systems, clinical software and digital X-ray units had been installed.
• 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 although we found that clinical waste was not stored securely.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Safeguarding contact details were available in the policy file. The safeguarding lead was trained to level three in the protection of 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs. The practice offered extended hours appointments opening until 8pm on Monday to Thursday; opening early from 8.30am on Monday to Friday, and opening from 9am to 2pm on Saturday.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements. However the closed circuit television cameras protocols did not fully reflect published guidelines.

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

• Review the practice’s protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
• Review the practice's waste handling protocols to ensure waste is stored securely prior to disposal in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01.