We carried out this announced inspection on 14 September 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.

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

Fen House Dental Practice is in Spalding, a market town in Lincolnshire and provides mostly NHS treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. There are limited car parking spaces at the front of the premises. There is also plenty of free on road parking without time restrictions within a short walking distance.

The whole dental team includes three dentists (including the practice principal), five dental nurses, two trainee nurses, three receptionists and a practice manager. The provider also has a second practice in Gosberton approximately seven miles from the practice. Staffing provision can be shared between the two practices if required, although staff tend to work in the practice they were recruited to.

The practice has two ground floor treatment rooms and one upstairs.

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 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, two receptionists 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 9am to 1pm and 2.30pm to 7pm, Tuesday 9am to 1pm and 2pm to 5pm, Wednesday 9am to 1pm and 2pm to 7pm, Thursday 9am to 1pm and 2pm to 5pm and Friday 9am to 1pm and 2pm to 5pm.

Our key findings were:

• The practice ethos included the provision of a comprehensive service to the whole population without discrimination.
• Effective leadership from the provider and practice management was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and life saving 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 and shared learning when untoward incidents occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice were aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided.

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

• 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.
• Obtain documentation to identify all staff Hepatitis B immunity levels and take appropriate and immediate action to manage any risks where appropriate.

Fen House Dental – Spalding is located in the market town of Spalding in Lincolnshire. It currently has three dentists and a list size of about 7000 patients. The patients are mainly NHS and the surgery works with the local Primary Care Trust (PCT) who allocates patients to them from an NHS waiting list.

We spoke with two members of staff, the dentist and one patient who was visiting the service at the time of our visit.

The patient we spoke with told us, “Things [treatments] are discussed fully and you are given an explanation of the options available.”