We carried out this announced inspection on 20 November 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

Corser House Dental Practice is in Whitchurch and provides NHS and private treatment to adults and children.

The practice is situated in a listed building and there is no level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including two for blue badge holders, are available near the practice.

The dental team includes two dentists, two dental nurses (one of whom is a trainee) and one dental hygiene therapist. The practice is part of a corporate and the leaders work across and oversee all the practices in the group. The practice has one treatment room.

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. At the time of inspection there was no registered manager in post as required as a condition of registration. A registered manager is legally responsible for the delivery of services for which the practice is registered. Staff informed us that a staff member was in the process of applying for this role.

On the day of inspection, we collected 15 CQC comment cards filled in by patients.

During the inspection we spoke with two dental nurses and the business development director. None of the clinicians were present during our visit. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday: 9am - 6pm

Tuesday: 9am – 5pm (no dentist on site)

Wednesday: 9am – 5pm (no dentist on site)

Thursday: 8am – 5pm (no dentist on site between 1pm and 5pm)

Friday: 9am – 5pm

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 with the exception of one item. This was immediately ordered.
• The practice had systems to help them manage risk to patients and staff. We identified some necessary improvements such as staff awareness of fire safety.
• The provider had safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The previous registered manager had ceased working at the practice a few weeks before our visit and the practice had not yet filled this position. An application had been made by an individual for this role. The practice’s auditing processes required improvements.
• 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.

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

• Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.
• Review the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities.
• Review the practice's protocol and staff awareness of their responsibilities in relation to the duty of candour to ensure compliance with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
• Review the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.
• Review the practice’s protocols to ensure audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017. In particular, the use of rectangular collimation to reduce the radiation dose to patients.