We carried out this announced inspection on 3 October 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.

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

Dr Fazal Rahman practice is more commonly known as Dr Rahman’s Smile Studio which is a long established dental practice located in a converted residential property in Rugby. The surgery provides predominantly NHS treatments with some private upgrades to patients of all ages.

There is level access for people who use wheelchairs and pushchairs however, the dental treatment room is located on the first floor accessed by stairs. The ground floor of the practice consists of a reception area, a waiting room, a patient toilet, and a filing room. On the first floor there is a staff room, an office and one dental treatment room with an area for decontamination for the cleaning, sterilising and packing of dental instruments. Car parking spaces, including spaces for blue badge holders, are available in the pay and display car park which is a short walk from the practice.

The dental team includes the principal dentist, the practice manager who is a qualified dental nurse and one trainee dental nurse. The practice has one dental treatment room.

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. This information gave us a positive view of the practice.

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

The practice is open:

Monday: 9am – 6pm

Tuesday: 9am – 6pm

Wednesday: 9am – 1pm

Thursday: 9am – 6pm

Friday: 9am – 6pm

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 with the exception of defibrillator pads and bandages which were past their expiry dates; these were re-ordered on the day of our inspection.
• 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 appointment system met patients’ needs. Patients could access treatment and urgent and emergency care when required.
• 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, results of improvements made as in response to patient feedback were displayed in reception.
• The practice dealt with complaints positively and efficiently.

When we visited this service on 20 February 2013, we looked at the premises and spoke with the dentist, a dental nurse and a trainee dental nurse. They told us they enjoyed their work. We spoke with five people who used the service. They all told us the service was very good and they wanted to continue using this service. One person said, "I have had very good treatment. The dentist is very gentle, very patient." Another person told us, "He is always courteous, I get a good service.”

In the five patient records we looked at, we saw that people were asked about their medical histories and any medical issues that might impact on people's dental treatment were clearly recorded. We saw that people decided which type of treatment they wanted and had signed to say they agreed with their dental plan.

We watched how staff cleaned the surgery after each patient and how they sterilised the used equipment. We saw that the surgery was clean, equipment was stored safely and that staff followed the department of health guidance for infection prevention and control.

We saw that the dentist kept records of staff's training, of feedback received from patients and of the other quality checks they made. We found that the results of their checks were discussed at staff meetings, which meant that all staff were aware of any issues and actions they should take to maintain the quality of the service.