We carried out this announced inspection on 17 January 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

Churchgate Dental Clinic is situated in the market town of Retford in north Nottinghamshire. The practice provides a mixture of private and NHS dental treatments to patients of all ages.

The practice has one treatment room which is located on the ground floor. There is a pay and display car park outside the practice, which includes parking for blue badge holders.

The dental team is undergoing a number of changes with cover provided from a sister practice in Gainsborough. The dental team includes: one dentist; one dental hygienist/ therapist; one qualified dental nurse; 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 the practice is the former owner, although this is in the process of being changed.

On the day of inspection we received feedback from three patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, one dental hygienist/ therapist, one dental nurse and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice opening hours are: Monday: 9am to 5.30pm with the dental hygienist/ therapist; Wednesday: 2pm to 5.30pm and Friday: 9.30am to 1pm. The practice does have a degree of flexibility in that it will open at other times based on patient need and demand.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The security of NHS prescription pads needed to be tightened with better tracking and record keeping.
• The practice had suitable safeguarding processes. Staff had been trained and knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took measures to protect their privacy and personal information.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice did not have an induction hearing loop to assist patients who used a hearing aid.
• The practice dealt with complaints positively and efficiently.

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

• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

We spoke with three people who used the service, the dentist, the dental nurse and the receptionist. We also looked at records. These included treatment plans, details of meetings and information about how the service operated. We looked at information from surveys and audits undertaken by the provider to assess the quality of the service.

People said they had been told about the treatments available and the costs involved, so they could make an informed choice. They told us the staff were friendly and helpful and treated them with respect. We spoke with three patients and they all expressed satisfaction with the care and treatment they received.

Comments from a survey included, “Everyone is always attentive and sympathetic. The receptionist is always friendly and helpful.”

Patients said they always found the environment to be clean and tidy and said that staff wore protective equipment when treating them. We saw that the practice had an infection control policy and staff had received training in infection control.

The provider had systems in place to monitor and improve the service provided to patients.