We carried out this announced inspection on 12 July 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

Diplomat Devon Limited - Dawlish is situated in an industrial estate in Dawlish and provides NHS treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs (although facilities are not fully wheelchair accessible). Car parking spaces are available at the practice.

The dental team includes two dentists, one dental hygienist and two dental nurses. The practice has two treatment rooms.

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. The registered manager at Diplomat Devon Limited - Dawlish was the principal dentist.

On the day of inspection we collected 19 CQC comment cards filled in by patients and spoke with one additional patient. This gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses and another of the practice owners. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Mon to Thu 9am – 1pm. 2pm – 5pm. Fri 9am – 2pm.

Our key findings were:

• The practice staff 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 but improvements could be made to assess and manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• 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.
• 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 in a timely manner.
• The practice staff had suitable information governance arrangements.
• The practice provided a valuable dental service to a local mental health hospital.

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

• Review its responsibilities to respond to meet the needs of patients with disability and the requirements of the Equality Act 2010.

• Review the practice risk assessments to ensure all identified risks are monitored and mitigated and all actions are completed promptly. In particular with regard to use of rubber dam, risk of sharps injury, access to dental treatment rooms during X-rays being taken and fire.

• Review the suitability of worktop and flooring/skirting board condition in the decontamination room taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.

• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established.

We spoke to four patients who were all very complimentary about the practice. They felt that they were treated with respect and dignity. They told us that they were informed about the choices, costs, alternatives and possible outcomes of their treatment.

One patient told us that the staff and dentists were "Absolutely brilliant". Another said "I am very happy, it is worth travelling a long way to get here". People felt they were being treated in a clean and caring environment, and always given privacy. One patient said that "Privacy was very good". We found the practice to be clean, comfortable and caring. Another patient told us that it was his first visit and that he was "Strongly recommended to come to this practice".

We found overall that the patients felt they were being treated well and that they found the staff well trained and organised.

The practice was friendly, welcoming and informative. We saw that patients were listened to in all areas of the practice. The surgery was clean throughout and there was evidence of good quality service delivery. Patients were well informed to enable them to give consent appropriately and the staff were well trained and caring. The practice was well led, and the staff were observed to be well organised.