We carried out this announced inspection on 2 October 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 told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information for us to take into account.

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

Charnwood Dental Shepshed is located in Charnwood in Leicestershire. It provides NHS and private treatment to patients of all ages.

There is stepped access at the front of the practice premises. The practice have access to a portable ramp to assist people who use wheelchairs and pushchairs. The practice also direct their patients with mobility problems to a level access entrance at the rear of the building. There is limited car parking on site for patient use but there are public car parks and on street parking near to the practice. These parking facilities include allocated spaces for blue badge holders.

The practice is a listed building and any modifications are therefore restricted.

The dental team includes six dentists, six dental nurses, two trainee dental nurses, one dental hygienist, two dental hygiene therapists and three receptionists. The practice also employs a practice manager. The practice has five treatment rooms, all located on the ground floor.

The practice owner is a registered dentist and has a contract with NHS England to undertake domiciliary visits to people who reside in Leicestershire by way of referral only. The dentist and the practice manager (who is also a qualified dental nurse) visit patients in their own home or care facility.

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 Charnwood Dental Shepshed is the practice manager.

On the day of inspection we collected 31 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, two dental nurses, one trainee dental nurse, one dental hygienist therapist, a receptionist 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 9am to 5.30pm, Tuesday and Wednesday 8.30am to 5.30pm, Thursday 8.30am to 6.30pm, Friday 8.30am to 5pm, Saturday and Sunday 9am to 1pm.

Our key findings were:

• The practice ethos included the provision of regular care at appropriate intervals for their patients. Objectives included the promoting of good oral health and ensuring patients understood and were involved in their care.
• Effective leadership from the provider and practice management was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and life saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting and shared learning when untoward incidents occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice were aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided.

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

• Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the use of risk assessments to monitor and mitigate the various risks arising from undertaking of the regulated activities, specifically in relation to lone working and domicillary visits.
• Ensure that appropriate vehicle insurance is in place when transporting oxygen and that a sign is displayed on the vehicle to inform the public when oxygen is being carried.

People felt they were given enough information to make a decision about treatment and that they were given more information if they wanted it: "It’s there if you need it."

They also said that who ever provided the dental care did so in a considerate manner and always included them in any decisions.