We carried out this unannounced inspection on 26 September 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.

We told the NHS England area team that we were inspecting the practice. They provided information which we took into account.

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

Country Dental Practice is in Wallcrouch, East Sussex and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including some for patients with disabled badges, are available in the practice grounds.

The dental team includes one dentist, one dental nurse and two receptionists. The practice has two treatment rooms; one of which is not in continuous use.

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 this occasion we did not supply CQC comment cards to be filled in by patients as this was an unannounced inspection. We did speak with one patient on the day of our visit and two patients prior to our visit.

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

The practice is open:

Monday to Thursday 9am to 5pm

Friday 9am to 12.30pm

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 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 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.

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

• Ensure that all clinical sessions are supported by a dental nurse in line with the GDC Standards for dental professionals.
• Ensure that all schedule three documents are available and that DBS checks are carried out for all clinical staff.

We spoke with the dentist, one dental nurse, the receptionist and three people who used the service. People told us that they were fully involved in the planning of their treatment. The dentist discussed different options available with people and enabled them to make informed decisions about their care. One person told us, "The dentist is discussing each step well in advance and I have time to consider everything before we go ahead". The dentist reviewed and updated the care plans at the beginning of each visit. One person told us, "I am totally satisfied, my teeth needed complex work and all was superbly done, this is a very good dentist, I have been coming here for years".

We saw that Country Dental had a policy and procedures in place for safeguarding children and adults at risk. The staff knew where to access this information should they suspect abuse taking place.

We saw that the service maintained appropriate standards of cleanliness and hygiene throughout the premises. Staff told us, "I ensure that all cleaning and decontamination processes have been followed daily. We keep a high standard of cleanliness in the practice and follow a strict cleaning routine at the end of each day". One person who used the service told us, "The place is always ever so clean and spotless".

Audits were carried out to identify how the service could improve. We found that the service had an effective incident reporting system and a complaint policy with clear procedures.