We carried out this announced inspection on 02 November 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

East Preston Dental Clinic is located in East Preston, close to Littlehampton. It provides private treatment to patients of all ages.

The practice occupies ground floor premises. There are two treatment rooms which are wheelchair accessible. There is separate reception and patient waiting area and a separate sterilisation room.

The dental team includes the principal dentist, one associate dentist, two qualified dental nurses, two dental hygienists, two receptionists and a practice manager.

The practice is owned by an individual who is the principal dentist. 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.

During the inspection we spoke with the principal dentist, both dental nurses, one dental hygienist, one receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

On the day of inspection all 50 CQC comment cards sent ahead of the inspection had been filled in by patients. This information gave us an entirely positive view of the practice.

The practice is open: Monday to Friday from 8am to 8pm and Saturday’s from 8am to 1pm. The reception desk is open Monday to Friday from 9am to 6pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which required updating to reflect current 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 appointment system met patients’ needs.
• The practice had effective leadership. Staff felt supported.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

We found areas where the provider could make improvements and should:

• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
• 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 staff training to ensure that all of the staff have undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.

We spoke with three people who used the service. They were all happy with the care and treatment they received and the way in which it was delivered. One person told us, "The staff are so welcoming. It's almost a pleasure".

We saw before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We noted people's verbal and written consent was obtained before care and treatment was undertaken. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their treatment. People were cared for, or supported by, suitably qualified, skilled and experienced staff.

We observed the care given was safe and appropriate. Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. There were arrangements and equipment in place to deal with medical emergencies. We saw there were effective systems in place to reduce the risk and spread of infection. We also found systems were in place for people and relatives to make a complaint about the service if necessary.

We spoke to three people who agreed to speak to us over the telephone after their appointments.

They told us that they were very satisfied with the service provided. One person told us, “This is the first dentist I have felt confident in to carry out the reconstruction work I have needed.” Another person said, “I am a new patient and this dentist was recommended to me. I would have no hesitation in recommending him on to others.” A third person told us, “De Steffin is very good, actually. He has done an excellent job for me.”

They told us they were given information about their treatment options and the relevant fees. They had also been given time to consider the options before agreeing to treatment. They told us they were able to ask all the questions they wanted.

They also said the staff were friendly and welcoming. They informed us they were treated with respect and their privacy was maintained when receiving treatment.