We carried out this announced inspection on 22 May 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.

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

Coppertop Surgery is in Camberley and provides NHS and private treatment to adults and children.

There is level access for people with pushchairs once inside the practice. Car parking spaces are available near the practice.

The dental team includes one practice manager, three dentists, four dental nurses, four dental hygienists, and four receptionists. The practice has five treatment rooms.

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 Coppertop Surgery was the principal dentist.

On the day of inspection we collected 47 CQC comment cards filled in by patients

During the inspection we spoke with two dentist, two dental nurses, two dental hygienist, two receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Mon to Friday 08.30 to 17.00 and alternate Saturdays mornings.

Our key findings were:

• The practice staff appeared clean and well maintained.
• The practice staff 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 staff 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Not all 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 staff dealt with complaints positively and efficiently.
• The practice staff had some suitable information governance arrangements.

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

• Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.

• Review the practice’s protocols to ensure audits of radiography, patient notes and antimicrobial prescribing and control 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.

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.

• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.

• Review the practice's storage of dental care records to ensure they are stored securely.

• Review the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.

• Review the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.

• Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular the practice managers office/staff room/kitchen.

People said they were very happy with their treatment. They told us the Dentist spoke to them directly. They said the Dentist listened to what they had to say about their treatment. They told us the Dentist made sure they understood their treatment and choice by giving information in a way they could understand and by using the first visit as a consultation visit where no treatment was carried out except in emergency. Some people said they had a full and thorough discussion regarding their medical and dental health and that they had x-rays taken.

People who used the service told us that they were provided with good information about the treatments and the cost of the different treatments and that they found the web site very helpful and informative as well as the written information provided. They said that staff were always polite and helpful.

People said that staff were good at discussing all their treatment options and they felt they had realistic expectations of the procedures they were having.

People told us that the practice was comfortable and accommodating and that appointments were flexible to meet their needs. People told us on the rare occasions when they needed an urgent appointment they were seen on the same day. People told us the Dentist asked them questions about their medical health at each visit. People said a range of treatment was discussed with them, but they made the choice of treatment they wanted.

People spoken to in telephone interviews told us the practice is a family friendly practice. Some people said our whole family including our grand children are cared for at this dental practice.

People told us they were very confident in the abilities of the staff at the surgery.