We carried out this announced inspection on 7 February 2019 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

Compton Acres Dental Practice is in the West Bridgford area of Nottingham and provides mostly private dental treatment to adults and some children on an NHS contract.

There is level access for people who use wheelchairs and those with pushchairs. There is car parking available at the practice including spaces for blue badge holders.

The dental team includes three dentists, one dental hygienist, six qualified dental nurses, including the practice manager. Dental nurses work on reception as part of their duties. The practice has three treatment rooms, all of which are on the ground floor.

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 Compton Acres Dental Practice is the principal dentist.

On the day of inspection, we collected three CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with the practice owner, two dentists, 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 is open for NHS patients: on Monday from 9am to 3.30pm and Tuesday to Friday from 10am to 3.30pm. The practice is closed on Saturday and Sunday.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had most of the staff recruitment information required by the Regulations.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• Audits at the practice did not always have action plans or learning points to demonstrate that improvements had been achieved.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

• Review the practice’s protocols to ensure audits are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

We used a number of different methods to help us reach a judgement on this service. These included talking with patients using the service, members of the staff team, observation and looking at records.

We spoke to three patients, two dentists, one hygienist, two members of practice staff and the practice manager. We also looked at records. These included care plans, records of meetings and information about how the service operated. We looked at information from surveys undertaken by the provider to assess the quality of the service.

Patients we spoke to were involved in their care and treatment options, they felt care was delivered in a safe way and that the practice was very clean and hygienic. One patient said, “The practice is always immaculately clean.”

One patient said, "My dentist has been brilliant and the service is excellent." Another patient said, "The treatment I have received has revolutionised my life."

We observed members of staff interacting with patients in a very courteous, polite and efficient manner.

We saw that the practice had implemented an effective infection control policy and that staff were encouraged to develop their skills and undertake appropriate training to help deliver safe and effective care to patients.