We carried out this announced inspection on 22 January 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.

We told the NHS England area team that we were inspecting the practice. We did not receive any information of concern.

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

Cramond House Dental Practice is based in Clitheroe and provides private treatment for adults with some NHS provision for children.

There is provision for level access for people who use wheelchairs and pushchairs. Car parking spaces and public transport facilities are available near the practice.

The dental team includes three dentists, two dental hygienists, ten dental nurses (one of whom is a trainee) and a receptionist.

The practice is jointly owned and registered to 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 50 CQC comment cards filled in by patients. This information gave us a very positive view of the practice.

During the inspection we spoke with the three dentists, two dental nurses, one dental hygienist and the receptionist/ 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 5:30pm. Friday 9 am to 5pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance. The signage of the decontamination needed review to ensure authorised access only.
• Staff knew how to deal with emergencies. Emergency equipment and medicines were available as described in recognised guidance.
• 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 a recruitment policy in place and this had been adhered to.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• Staff took care to protect patient privacy and confidentiality; some of the patients records needed secure storage.
• The appointment system was flexible and 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 and should:

• Review the signage for the decontamination room door to clarify to patients and visitors this is a restricted area.
• Review the safe storage of patients’ records taking into account guidelines published by the Information Commissioner's Office (ICO).

People told us they were satisfied with the care and treatment provided at Cramond House Dental Practice. One person said, “I’m very happy, my dentist is helpful and makes me feel comfortable” and another person commented, “I’ve no problem, everything is always explained very well”.

People spoken with confirmed they were aware of their treatment plan and said they had discussed various treatment options with their dentist. People also said they were treated with respect and their queries were answered in a sensitive and understanding manner.

Staff had an understanding of safeguarding children and vulnerable adults procedures and knew who to contact in the event of a concern.

People were treated in a clean environment and arrangements were in place for the safe decontamination of reusable instruments and equipment.

People were aware how they could raise any concerns and suitable arrangements were in place to respond to any complaints. None of the people spoken with had any concerns about the service.