We carried out this announced inspection on 15 June 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 provide any information which we took into account.

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

Oasis is in Wells and provides NHS and private treatment to patients of all ages.

There is level access via portable ramp for people who use wheelchairs. The practice treatment rooms are all on ground level. Car parking spaces, including for patients with disabled badges, are available near the practice.

The dental team includes nine dentists, four dental nurses and two trainee dental nurses, one dental hygienist and three receptionists. The practice has five 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 Oasis Wells was the practice manager.

On the day of inspection we collected 10 CQC comment cards filled in by patients and spoke with six other patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, three dental nurses, two receptionists, the practice manager and the regional compliance officer. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday: 8am to 7pm and Friday: 8am to 5pm Saturday and Sunday: Closed (open one Saturday per month).

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. 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, although it was not clear if the safeguarding training met the minimum requirements.
• 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, although it was not clear if the practice had access to appropriate interpretation services.
• Staff took care to protect patient 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 were areas where the provider could make improvements. They should:

• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development (CPD)

• Review availability of an interpreter services for patients who do not speak English as a first language.

On the day of our visit we spoke with eight people who were complimentary about the practice. All felt they were treated with respect and dignity, however a couple of people told us they often had to wait beyond their appointment time with no information about the delay. We observed verbal consent to treatment was obtained prior to treatment thus respecting people's wishes. All eight people told us they were informed about the treatment alternatives and possible outcomes of the treatment.

One person told us "this is an excellent practice I've been coming for years and so have all the family". Two other people told us they had confidence in the dentist they saw and had no concerns.

We saw a patient satisfaction survey was used to gather feedback. The results of the last survey in March 2014 demonstrated people were very happy with all aspects of the practice. People told us they could make an appointment at times that suited them. They told us they were aware of the emergency number. However not all people reported they could get an appointment within 24 hours.

The practice had access for people with disabilities including wheelchair users through the front of the building. Once in the practice there were facilities on the ground floor to provide all the services offered by the practice.

Systems were in place to ensure staff were appropriately supported in relation to their responsibilities, which enabled them to deliver care and treatment to people safely and to an appropriate standard.

We saw effective systems were in place to monitor and improve the quality of the service provided. These had been recently implemented by the new manager of the practice.