We carried out this announced inspection on 5 February 2019 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. A dentist who is a registrar in Dental Public Health also joined our inspection as an observer.

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

Diana Dental is in Stoke on Trent and provides NHS and 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 two dentists, two dental nurses (one of whom was a trainee dental nurse), two dental hygienists, two dental hygiene therapists and one receptionist. There was also a clinical manager and one development manager and both were qualified dental nurses. The practice has four treatment rooms and a separate room for carrying out decontamination.

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 18 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, one dental nurse, one receptionist, the clinical manager and the development manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday: 8.45am – 7pm

Tuesday/Wednesday/Thursday: 8.45am – 5pm

Friday: 8.45am – 4pm

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 medicine that was in the incorrect format. This was promptly ordered.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. All staff apart from one trainee dental nurse had completed training in safeguarding.
• The provider had staff recruitment procedures. Improvements were needed to ensure complete immunisation records were available for all clinical staff members.
• 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 provider had effective leadership and a culture of continuous improvement.
• 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.
• The provider had suitable information governance arrangements.

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

• Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• 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.

We carried out this inspection as part of our schedule of inspections to check on the care and welfare of people who used this service. The inspection was announced, which meant that the provider and the staff knew we were visiting. On the day of our inspection we spoke with six people, the provider, four staff and looked at four treatment records. People who received treatment at the dental practice told us they were very happy with the care that they received. One person told us, “It’s excellent here. I don’t think I could get this level of care anywhere else”. Another person told us, “There are no problems here. The staff are pleasant and put you at your ease”.

People told us they were always treated with dignity and respect. Throughout our inspection we saw that people were communicated with in a professional and friendly manner. The practice was clean and tidy and there were systems in place to protect people from the risks of infection.

We saw that people experienced care and treatment that met their needs because they were cared for by suitably qualified, skilled and experienced staff.

We saw evidence that the provider regularly assessed and monitored the quality of service that people received.