We carried out this announced inspection on 4 April 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

This BUPA dental practice is in Skegness and provides NHS and private treatment to patients of all ages.

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

The dental team includes three dentists, three qualified dental nurses, two trainee dental nurses, one receptionist and a practice manager and a practice co-ordinator. The practice has four treatment rooms.

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 BUPA Skegness is the practice manager.

On the day of inspection we collected 24 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists, two dental nurses, two 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: 9am to 6pm; Tuesday: 9am to 7pm; Wednesday: 9am to 6pm; Thursday: 9am to 7pm; Friday: 9am to 6pm and Saturday: 9am to 1pm (2 Saturdays per month).

Our key findings were:

• The practice appeared clean and well maintained.
• The practice 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.
• 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 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 dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

People we spoke with told us they felt fully informed about and were also able to ask questions about the treatment they received. One person said, "The dentist gives me all the options. If there any costs, I am told how much it will be.”

Members of staff we spoke with told us they had received training about medical emergencies and also received regular updates. We saw staff training records confirming this.

People we spoke with all told us that they thought that the premises and treatment rooms were clean. One person who used the service told us, “I have always found the practice clean.”

We noted that the practice had a separate decontamination room for cleaning and sterilising instruments.

We reviewed documents and action plans that showed us that the practice carried out regular checks to see if infection control procedures were implemented properly. They showed equipment used to decontaminate instruments was appropriately tested and checked to ensure it worked effectively

We saw the practice's current complaints procedure, which was displayed in the waiting room. We were told by the practice manager, how they would work with the patient to resolve their complaint within 10 days of receipt.