We carried out this announced inspection on 9 May 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

Carmelite Dental Practice is in Maldon and provides NHS (90%) and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including places for blue badge holders, are available near the practice.

The dental team includes two dentists, three dental nurses, one dental hygienist and one receptionist. At the time of the inspection the practice team included two apprentice dental nurses. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 27 CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with two dentists, two dental nurses and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday from 9am to 6pm, Friday from 9am to 5pm. The practice is closed between 1pm to 2pm Monday to Friday.

Our key findings were:

• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were mostly available with the exception of some items including some doses of adrenalin, a reservoir bag and clear face masks which were immediately ordered.
• 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 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. Patients could access routine treatment and urgent and emergency care when required.
• The practice had effective leadership and culture of continuous improvement.
• 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities in relation to this.