We carried out this announced inspection on 10 May 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 did not have information from either the NHS England area team or Healthwatch to take into account in our planning for this inspection.

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

Butler and Finnigan Dental Practice is in Bishops Castle and provides NHS and private treatment to patients of all ages.

Many of Bishops Castle’s streets are steep and the practice is at the top of a hill but there is level access into the building for people who use wheelchairs and pushchairs. A small number of car parking spaces are available near the practice.

The dental team includes seven dentists, six dental nurses (one of whom is the practice manager), and one dental hygienist. The dental nurses share reception duties. Most members of the team at the practice are part time The practice also has a small bank team of two dental nurses and a receptionist to provide cover during annual leave and sickness. The practice has two 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 Finnigan and Butler Dental Practice is one of the two company directors, both of whom are dentists at the practice.

On the day of inspection we collected 21 CQC comment cards filled in by patients. Young children had filled in three of these. They had drawn pictures of smiling faces and written that they liked the dentist. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses 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 to Friday from 9am to 5pm. Staff have a lunch break between 1pm and 2pm but told us they often continue to answer the telephone and deal with people who call in. On days when they close for lunch they put the answerphone on and put a sign on the door.

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 a staff recruitment policy but did not have detailed guidance about the information required when recruiting new staff.
• 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 were areas where the provider could make improvements. They should:

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and their responsibilities under the Act as it relates to their role.
• Review procedures relating to staff recruitment so these include the specific recruitment checks described in the relevant legislation.