We carried out this announced inspection on 25 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

Ernevale House Dentistry is in Spalding, a market town in Lincolnshire. It provides private treatment to patients of all ages.

There is one step to gain access to the premises and a further step inside the premises to access the reception area. The practice has made reasonable efforts, where possible, to accommodate people who use wheelchairs and pushchairs. The practice is however, unable to use a portable ramp because of the physical design of the entrance. Patients with mobility problems are seen in a treatment room on the ground floor.

Car parking spaces, including those for patients with disabled badges, are available directly outside of the premises on the street and also in a public car park at the rear of the building.

The dental team includes three dentists, (including the principal dentist), four dental nurses (including a trainee nurse), one decontamination assistant, one dental hygienist and one receptionist. A practice manager is also employed and one of the practice owners assists the manager in any aspects of their role.

The practice has four treatment rooms; two of these are on the ground floor. The surgeries have been refurbished and plans are also in place to modernise the staff and public areas.

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 Ernevale House Dentistry is one of the practice owners.

On the day of inspection we collected 46 CQC comment cards filled in by patients. This information gave us a positive view of the practice. We did not receive any negative feedback about the practice.

During the inspection we spoke with two dentists, two dental nurses, the practice owner 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, Tuesday and Thursday 9am to 5.30pm, Wednesday 9am to 6pm, Friday 9am to 2.30pm and Saturday 9am to 2.30pm.

Our key findings were:

• Effective leadership from the provider and practice manager was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and lifesaving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when they occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice was aware of the needs of the local population and had taken some of these into account when delivering the service.
• Patients had access to routine treatment and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• The practice dealt with complaints positively and efficiently.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• Governance arrangements were embedded within the practice.

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

• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.