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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information.

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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Genix Healthcare Dental Clinic - Lister House is in the centre of Gloucester and provides NHS and private treatment to patients of all ages.

There is level access into the ground floor of the building with a lift to the second floor where the surgery is based. This provides access for people who use wheelchairs and pushchairs. Car parking spaces are available in local public car parks.

The dental team includes 10 dentists, eight dental nurses and two trainee dental nurses; a practice manager and four receptionists. The practice has nine treatment rooms.

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 Genix Healthcare Dental Clinic - Lister House was the practice manager.

On the day of inspection we collected five CQC comment cards filled in by patients and spoke with three other patients. This information gave us a positive view of the practice.

During the inspection we spoke with five dentists, three 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, Wednesday & Friday 9.00am – 5.30pm;

·Tuesday & Thursday 09.00am – 7.00pm;

·Saturday 09.00am- 2.00pm.

·Out of hours information displayed on website and via telephone answering service.

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.
• 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 involved, 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.

We did not speak to people who used the service. This was a follow up inspection to check on three compliance actions following a previous inspection. We found improvements to the environment of the practice. Remedial work had been carried out following damage by rain water entering the building and the lift had been repaired and was in working order. We also found an improvement in staff training relating to safeguarding adults and children. In addition there were arrangements in place to ensure that important incidents affecting the practice were reported to us.

We spoke with four people who used the practice. They all told us that the staff at the practice were polite and respectful to them. One person told us, “I was made to feel very welcome", when they first came to the practice. People told us how they had their dental treatment explained to them. We also heard positive comments from two people about the dental treatment they had received in an emergency.

Everyone we spoke to said that the practice environment was clean when they visited. We also found that there were effective procedures in use for the decontamination of dental instruments. When we looked at safeguarding, we found that the majority of staff had not received training relevant to protecting people from abuse. In addition staff appraisals had not taken place since the end of 2011. We found that the practice had an effective complaints system in operation although none of the people we spoke to had cause to make use of it.