We carried out this announced inspection on 9 August 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 us with any information to take into account.

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

Hampton House Dental Practice is located in Lutterworth and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. There are a limited number of car parking spaces available at the rear of the practice’s premises for patients to use. At present, there is no allocated parking for patients who are disabled badge holders. Public car parking is available within Lutterworth town centre or on side streets which are close to the practice’s premises.

The dental team includes five dentists, one is an orthodontist, five dental nurses, two of the nurses also work as receptionists and there is one dental hygienist. The practice has four treatment rooms; all of these are on the ground floor.

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.

The provider is also a partner in another practice of the same name which operates from a location in Leicester.

On the day of inspection we collected 39 CQC comment cards completed by patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, two dental nurses (one of whom also worked as a receptionist) and a second receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday to Thursday 8.30am to 12.30pm and 1.45pm to 5.15pm. On Friday the practice is open 8.30am to 2.45pm.

Our key findings were:

• The practice ethos included the provision of dental care and treatment of a consistently good standard to meet patients’ needs and wishes.
• Effective leadership was evident in most areas of the practice. We noted some areas where management arrangements could be strengthened.
• Staff had been trained to deal with emergencies and appropriate medicines and lifesaving equipment were 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.
• 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 most of the local population and took some of these into account when delivering the service.
• Patients had access to treatment and urgent care when required.
• Whilst staff received training and clinical staff were supported in their continued professional development (CPD), their annual appraisals / performance reviews were overdue completion.
• 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 sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp instruments in Healthcare) Regulations 2013.
• Regularly monitor and record water temperatures as part of the legionella risk assessment taking into account guidelines issued by the Department of Health – Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• Review the practice protocols for the use of rectangular collimators.
• Review the staff supervision protocols and ensure an effective process is established for the on-going appraisal of all staff.