We carried out this announced inspection on 12 September 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

North Walsham Dental Care is a well-established practice which provides both NHS and private treatment to adults and children. The dental team includes three dentists, two hygienists, five nurses, three receptionists and a practice manager. The practice has six treatment rooms.

The practice opens on Mondays and Tuesdays from 8.30 am to 7pm; and on Wednesdays, Thursdays and Fridays from 8am to 6pm. The practice is also open on Saturdays from 8.30 am to 1pm.

The practice does not have its own parking facilities, but there is on street parking nearby. Wheelchair access is available to the rear of the property via a portable ramp, and there are ground floor 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 the practice is the practice manager.

On the day of inspection, we collected six CQC comment cards filled in by patients and spoke with four other patients. We spoke with two dentists, three dental nurses, one dental hygienist, one receptionist and the practice manager. One of the provider’s area compliance leads was also on site. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice appeared clean and well maintained.
• Infection control procedures reflected published guidance.
• Staff knew how to deal with emergencies, and appropriate medicines and life-saving equipment were available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had thorough staff recruitment procedures.
• Patients’ care and treatment was provided in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Opening times were good and the practice offered evening and Saturday morning appointments.
• The practice took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted upon.
• The practice was experiencing significant recruitment problems which were adversely affecting the availability of appointments and waiting times for treatment.

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

• Review the practice’s sharps procedures and ensure the practice follows the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

Prior to our visit we spoke with one person whose relative had received treatment at the practice and during our visit we spoke with five people who were waiting to see the dentist. The five people we met told us that staff were good at explaining their treatment and the options available to them before they consented to treatment. They said staff were kind and helpful and that they put them at their ease.

People told us that they were happy with the treatment they received and the response from the practice if they required urgent treatment. They said they had no concerns about cleanliness within the practice.

One person we spoke with had previously expressed concerns about their experience; however these had been addressed appropriately.