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 have any relevant information to share with us regarding this dental practice.

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

The Belper Dental Practice is located in premises in the centre of Belper and provides mostly NHS dental treatment (70%) to patients of all ages.

The practice is located on the ground floor with ramped access to the front door. There are six treatment rooms, all of which are located on the ground floor. There is a pay and display car park opposite the premises.

The dental team includes six dentists; two hygiene therapists; four qualified dental nurses; two receptionists and one practice manager.

The practice is owned by an organisation 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 Belper Dental Practice is a senior manager within the organisation.

On the day of inspection we collected seven CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentist, three dental nurses 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 to Friday: 9 am to 5 pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and 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 measures 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 dealt with complaints positively and efficiently.

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

• Review the practice's current audit protocols in relation to X-rays to ensure audits are undertaken at regular intervals and where applicable, learning points are documented and shared with all relevant staff.

As part of this inspection we spoke with seven people who used the service and seven members of staff including two dentists.

The majority of people told us that they were treated with respect and involved in decisions about their care. One person who used the service stated that their dentist was “approachable”. Both dentists we spoke with ensured that people were given sufficient information and choice so they could make informed decisions.

The majority of people we spoke with were happy with the care provided. One person told us the provider was “Really good”, another stated “They make you feel really relaxed”. One person told us that the care provided was “extremely good” and that the treatment they received never caused them any pain.

There were effective systems in place to reduce the risk and spread of infection and staff understood the importance of these.

The provider had not carried out sufficient pre-employment checks on all staff members to ensure that they were suitable to work in this environment.

The provider had a clear complaints policy and there was information on display telling people how to complain. A number of complaints were still being investigated at the time of our inspection.