We carried out this announced inspection on 29 June 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

East Midlands Community Dental Association is located in premises in South Normanton and provides mainly NHS dental treatment (95%) to patients.

The practice is situated in purpose built ground floor premises giving level access for patients to the front door which made access easy for people who use wheelchairs and pushchairs.

The dental team includes eight dentists; one hygiene therapist; eight qualified dental nurses including the practice manager; three trainee dental nurses and two receptionists including one trainee. The practice has six treatment rooms, all of which are on the ground floor.

The practice is owned by an organisation 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 East Midlands Community Dental Association is the practice manager.

On the day of inspection we collected 30 CQC comment cards filled in by patients. In addition we spoke with three dental patients in the practice. This information gave us a positive view of the practice.

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

The practice is open: Monday to Friday: 8 am to 5 pm and Saturday: 9 am to 3 pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed 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 risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes and staff had been trained and 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 steps to protect their privacy and personal information.
• The appointment system met patients’ needs. Patients said they could get an appointment that suited them.
• 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.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We spoke with a dentist about how they obtained the consent of people who used the service. We were told about the process of describing treatment options that were available to people and how to present this in a way the person understood.

We spoke with two people who had received treatment at the time of our visit. We asked them about the care and treatment they had received. Comments included: “it was all explained properly”, “they’re always friendly and polite” and “my dentist is lovely, they went through everything with me”.

There were effective systems in place to reduce the risk and spread of infection. We reviewed the infection prevention and decontamination policies and found them to be up to date and comprehensive with responsibilities clearly defined. A dental nurse made a mistake whilst we were observing them decontaminating instruments. This was rectified and the practice manager told us about action they would take to ensure decontamination processes were being followed correctly.

We found there were effective recruitment and selection processes in place but the provider may find it useful to note that records of CRB checks being undertaken were not always recorded in staff members records.

The provider had an effective quality assurance system to monitor the quality of service provided.