We carried out this announced inspection on 30 October 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. The Deputy Chief Inspector for primary medical services was shadowing 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

Carisbrooke Specialist Dental Centre is located close to Leicester city centre. The practice provides private dental treatment primarily to adults.

The practice has two entrances, a stepped front entrance and a side entrance which is accessed via a ramp. Entry through the side entrance is via video communication with an automatic door release. The practice has ten treatment rooms, four of which are located on the ground floor. This is of benefit for people who use wheelchairs and those with pushchairs. There is a car park at the hotel next to the practice which is available for patients' use. Car parking for blue badge holders was available outside the practice, and there is also roadside parking available in the area around the practice.

The dental team includes 10 dentists of which one is an endodontic specialist, one is an orthodontist, three are prosthodontists and two are periodontal specialists. The dentists are supported by four dental hygienists, 13 qualified dental nurses, one trainee dental nurse, two treatment co-ordinators, one referral co-ordinator, four receptionists, one clinical manager and a practice manager.

The practice is owned by an organisation 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 Carisbrooke Specialist Dental Centre is the practice manager.

On the day of inspection, we received feedback from 13 patients.

During the inspection we spoke with five dentists, two dental hygienists, five dental nurses, the clinical manager 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 8.30am to 5.30pm; Tuesday 8.30am to 7pm; Wednesday 8.30am to 7pm; Thursday 8.30am to 5.30pm; Friday 8.30am to 5.30pm and alternate Saturdays 9am to 1pm. The practice is closed on Sunday.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance. The practice had not been completing six-monthly infection prevention and control audits as identified in the published guidance. Following the inspection we received an in depth infection prevention and control audit with a schedule showing regular audits going forward.
• Staff knew how to deal with emergencies. Appropriate medicines and most of the recommended life-saving equipment were available. Following the inspection we were informed by the practice manager the missing items had been purchased.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had all of the staff records required by schedule three of the Health and Social Care Act (2008)
• 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, although there was scope for improvement regarding audits completed in the practice.
• Staff felt involved and supported and worked well as a team.

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

• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular the practice should ensure that six-monthly infection prevention and control audits are completed and documented.