We carried out this announced inspection on 28 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

Grange Green Dental Practice is in Billericay and provides private treatment to patients of all ages.

The practice was taken over by the new provider in February 2017 and is undergoing a period of reorganisation, recruitment and refurbishment.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available at the front of the practice.

The dental team includes two associate dentists, one dental nurse, two dental hygiene therapists, two receptionists and a practice manager. The practice has three treatment rooms.

The practice is owned by a partnership 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 Grange Green Dental Practice was the principal dentist.

On the day of inspection we collected 51 CQC comment cards filled in by patients and spoke with three other patients. This information gave us a wholly positive view of the practice.

During the inspection we spoke with one dentist, one dental nurse, one dental hygiene therapist, 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 8am to 7pm and Tuesday and Friday 8am to 5.30pm. At this time the practice is closed Wednesday and Thursday for dental appointments, but is open from 8.30am to 5.30pm for telephone calls and hygiene therapist appointments. The practice also offers Saturday mornings by appointment only.

Our key findings were:

• Strong and effective leadership was provided by an empowered practice manager. Staff felt involved and supported and worked well as a team.
• The practice had only been opened with the new provider since February 2017 and as such they had not yet completed appraisals or audits although these are scheduled.
• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Appropriate medicines and life-saving equipment were available with the exception of some items that were missing at the time of the inspection. There was scope to ensure all staff knew how to deal with medical emergencies.
• 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 asked staff and patients for feedback about the services they provided. The practice was in the process of undertaking a patient survey.
• The practice dealt with complaints positively and efficiently. This included a review of all verbal complaints and comments.

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

• Review staff training & 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 its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.
• Review staff awareness of competency for young people under 16 and ensure all staff are aware of their responsibilities.