We carried out this announced inspection on 23 July 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

Castle Care Dental Practice is in Castle Bromwich, Birmingham and provides NHS and private treatment to adults and children.

There is ramp access to the ground floor reception and waiting area for people who use wheelchairs and those with pushchairs. The treatment rooms and patient toilet are located on the first floor of the practice, accessed by stairs. Car parking spaces are available at the front of the practice and local side roads provide on street parking.

The dental team includes three dentists, two dental nurses, one of which works as the receptionist, and two dental hygienists. The practice has two treatment rooms.

The practice is owned by a partnership 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 Castle Care dental practice was the practice manager who was present during this inspection.

On the day of inspection we received comments from 30 patients.

During the inspection we spoke with one dentist, two dental nurses employed by the practice (one who also worked as the receptionist), a dental hygienist, the practice manager and a compliance manager employed by Rodericks Dental Limited. We also spoke with an agency nurse working at the practice. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: 9am to 5.30pm Monday to Friday.

Our key findings were:

• The practice appeared clean and well maintained. Plans were in place to make changes to the unused treatment room and toilet on the first floor of the practice.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Not all appropriate medicines and life-saving equipment were available but these were purchased during the inspection.
• 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. Staff had received training regarding safeguarding vulnerable adults and children.
• The practice had thorough staff recruitment procedures. Some employment information was kept at head office and therefore not available to review during this inspection.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information. Staff had received training regarding information governance.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• Not all dental care records that we saw contained risk assessments regarding oral cancer, periodontal disease or caries if required. Basic periodontal examinations (BPE) were not recorded for children aged over seven years.
• The appointment system met patients’ needs.
• 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 results of the Friends and Family Test for June 2018 were on display in the waiting room.
• 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 the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.