We carried out this announced inspection on 22 February 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. NHS England provided us with some contractual information about the service.

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

Brunel Dental Centre is in Newton Abbot and provides urgent care, assessment, advice, continuing care, onward referral and oral health advice to special care groups whose needs have prevented them accessing dental care through General Dental Services.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including spaces for patients with disabled badges, are available near the practice.

The dental team includes a clinical director (who is also a dentist), four additional dentists, 11 dental nurses, one dental therapist, one practice manager (who is also a dental nurse) and three receptionists. The practice has two treatment rooms.

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

During the inspection we spoke with one dentist, three dental nurses, one dental therapist, the practice manager, the acting clinical director and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9am – 4:30pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies.
• The practice had systems to help them manage risk.
• The practice 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 appointment system met patients’ needs.
• The practice had effective leadership. 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 dealt with complaints positively and efficiently.

There was an area where the provider could make improvements. They should:

• Review protocols for domiciliary visits taking into consideration the British Society for Disability and Oral Health – Guidelines for the Delivery of a Domiciliary Oral Healthcare Service. In particular with reference to ensuring access to a defibrillator whilst providing domiciliary dental services.