We carried out this announced inspection on 25 June 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

Cricklade Dental Practice is in Swindon, Wiltshire and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes four dentists, four dental nurses, three dental hygienists, a receptionist and the practice manager. The practice has three treatment rooms, an X-ray room, a decontamination room and reception area. The practice is open Monday to Thursday 9:00am – 5:30pm and Friday 8:00am – 3:00pm.

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 the day of inspection we collected 48 CQC comment cards filled in by patients.

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

Our key findings were:

• The practice appeared 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 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.
• 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 had suitable information governance arrangements.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• 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 Accessible Information Standard to ensure people who have a disability, impairment or sensory loss get information in a format that they can access and understand.
• Review the practice’s protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.  

We spoke with three patients who had visited the surgery on the day of our visit. We asked them about the services provided by the dental practice.

People were complimentary about the appointment system, competence and professionalism of staff and the level of information provided when they had attended the practice. Comments included, “I would happily recommend them” and “they had taken their time to explain treatments to me and gave me a full breakdown of the cost”.

The provider sought consent for treatment and patient’s records were up-to-date and securely stored. People told us that they were advised on the course of treatment by their dentist before consenting to treatment.

The premises were clean and well organised and staff routinely followed infection control procedures when carrying out treatments.

Staff received training to keep their knowledge and skills up-to-date.

We found people had opportunities to contribute their views about the quality of the service. The provider had systems for monitoring the quality of services provided and had a complaints procedure. People told us they felt they would be listened to if they raised a concern or had a complaint about the services provided.