We carried out this announced inspection on 23 August 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

Grange Dental Care is in Grange over Sands, South Cumbria and provides private treatment to patients of all ages.

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

The dental team includes three dentists, four dental nurses, one dental hygienist and the practice manager. There was no designated receptionist. The dental nurses covered reception on a rota’d basis. The practice has three 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 Grange Dental Care was the practice manager.

On the day of inspection we collected 21 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, one dental nurse 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, Thursday and Friday 8.00am – 5.00pm

Wednesday 8.00am – 7.00pm

The practice is closed at weekends

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.
• 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.
• There was a system in place for designated responsibilities for the dental nurses in the practice.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

We identified areas of notable practice.

The practice manager was driven and committed to empowering the whole team through assigning responsibilities based on the skills of each member of the team, their strengths and interests. This gave staff a feeling of worth and inclusiveness in the practice.

This led to an effective, smooth running and productive practice where all staff were happy in their roles. Patients also received a positive experience in the practice because everything was very well run and all required checks, information, equipment and safety procedures were in place.

We spoke with people who used the service and they told us they were happy with the care they received:

“Really happy, best place I’ve been to”.

“The dentistry is high quality”.

“They are very careful that you don’t have pain”.

We found that people were given good information about their care and were involved in decisions about their dental care. The provider had quality assurance systems in place.

Staff told us that they felt supported and that there was “Very good teamwork” and that the provider “Was a good employer”. We saw that there were good training and development opportunities for staff.

The practice facilities were well maintained and clean.