We carried out an announced comprehensive inspection on 31 January 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Chard House Dental Practice is located on the outskirts of the town of Chard, Somerset. The practice provides primary dental care services for people who require dental procedures. The practice provides NHS patient care. There are five dental surgeries all situated on the ground floor. There is level access from the street and parking at the practice. Approximately 16,000 patients are registered at the practice.

The staff structure of the practice consists of three dentists, two dentists in their foundation year (being supervised after qualifying as dental practitioners) and a dental hygienist. The practice is a training practice for dentists in their foundation years after graduating. There is a practice manager, one dental nurse, seven trainee dental nurses and a receptionist (dental nurses also have receptionist roles).

The practice is open from Monday to Friday from 9.00am to 5.00pm (with extended opening hours on Tuesdays). There is availability for appointments on Saturdays on request. There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice does not currently have a registered manager. This is because the position for a practice manager is being advertised as the current practice manager (who was not a registered manager with CQC) was leaving the practice. The area manager told us that when the position is filled the successful applicant would apply to CQC to be the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 inspection took place over one day and was carried out by a CQC inspector.

Eight patients provided feedback directly to CQC about the service. All comments received were positive about the care they received from the practice. Patients were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• There were effective systems in place to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment text/phone reminders were available on request up to one week prior to appointments.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke with felt supported by the management team and were committed to providing a quality service to their patients.

During our inspection we received positive feedback from people who used the service. They felt involved in their treatment decisions and felt their dentist gave clear explanations so they could understand their treatment options. Some comments people made were; the dentist was “very good” and “no problems whatsoever, brilliant” and the reception staff were “absolutely brilliant, spot on.”

We found the practice had information available to inform people of different services available. The practice gained feedback from people who used the service and used their suggestions to improve their service. They had procedures in place to deal with medical emergencies and staff had been trained to deal with them.

The practice regularly audited its infection control processes and had actions in place if improvements were required. Staff were aware of the importance of safeguarding vulnerable adults and children and knew how it related to dental practices.