We carried out this announced inspection on 28 September 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.

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

Bosworth Dental Practice is in Market Bosworth, a market town in Warwickshire and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. There are limited car parking spaces on site for patient use including one for disabled patients. There are also public car parks near to the practice which include spaces for blue badge holders.

The dental team includes six dentists (including a cosmetic and implant dentist), seven dental nurses, (including one apprentice nurse), one dental hygiene/therapist, three receptionists and a practice manager. The practice has four treatment rooms, three of which are located on the ground floor.

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 at Bosworth Dental Practice is one of the dental nurses who also acts as the clinical lead.

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

During the inspection we spoke with three dentists, four dental nurses, the dental hygiene/therapist, three 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: Monday, Tuesday and Wednesday 8.30am to 5pm, Thursday 8.30am to 7pm and Friday 8.30am to 4pm.

Our key findings were:

• The practice provided a wide range of NHS and private services to the community.
• Effective leadership from the provider, registered manager and practice manager was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and lifesaving equipment was available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when any incidents or complaints occurred.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Staff were aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided.

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

• Review the practice’s sharps procedures and ensure compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the practice’s audit protocols to ensure audits such as dental record keeping are undertaken at regular intervals to help improve the quality of service. The practice should also ensure, that where appropriate, these audits have documented learning points and the resulting improvements can be demonstrated.

We spoke with three patients following their appointment with a dentist and asked them about their experience. Patients told us they were very pleased with the service. They told us about the treatment they had been recommended or had received and said that the dentist had given them information about their treatment options and what these entailed including information about fees.

Patients told us their appointments were on time and that they did not experience a delay in booking an appointment and that emergency appointments were readily available.

Patients told us they found the practice and treatment rooms to be clean and tidy and confirmed that dentists and dental nurses wore protective clothing when providing treatment.

Patients comments included: - “I find them really, really good.” “My dentist is absolutely fantastic with me, but also my whole family. I’d recommend him to anybody.”