We carried out this announced inspection on 25 April 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.

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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Cirencester Dental Practice is in the centre of Cirencester and is a purpose built practice providing private treatment to patients of all ages.

There is level access from the street for people who use wheelchairs and pushchairs and the practice has a lift to the first floor where all facilities are accessible. Car parking spaces are available near the practice. The practice is well located near a main bus route.

The dental team includes five dentists, five dental nurses, three dental hygienists, a clinical co-ordinator who is also a registered dental nurse, a receptionist, a practice manager and marketing manager. The practice has four 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 three CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.

During the inspection we spoke with four dentists, five dental nurses, one dental hygienist, the receptionist, practice manager and marketing manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday – Thursday 09.00am -5.00pm and Friday 08.00am -4.00pm. The practice is closed at weekends but the out of hours emergency arrangements are displayed on their website. Contact information is available from the practice telephone answering service.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff 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 care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice used digital radiographs via a patient screen to help explain necessary treatment to patients while in the chair.
• The practice had effective leadership. 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 dealt with complaints positively and efficiently.

We spoke with people when we visited the practice who were attending for treatment or check-ups. They each told us that they were happy with the service they received and had been attending the practice for many years. People told us “My dentist gives me options of available treatments” and “I am aware of the costs of my treatments and have been given an estimate which I accepted.

There were effective systems in place to reduce the risk and spread of infection. People that we spoke with said that the surgery was always clean and that they had no concerns about cleanliness or risk of infection.

We spoke with staff about child protection issues and care of vulnerable adults. They demonstrated an awareness of the differing types of abuse and said that any concerns they had would be reported to the 'lead person'. We spoke with the safeguarding lead person who told us they had attended an advanced course in safeguarding children and adults; they were able to talk about the reporting protocols and demonstrated an awareness of reporting procedures.

General Dental Council registration was up to date for each of the dentists and the qualified dental nurses. They each had to submit evidence of continued professional development (CPD) every three years in order to retain their registration.