We carried out this announced inspection on 8 May 2018 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 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

Haynes Road Dental Practice is in Westbury and provides child only and some exempt NHS services. The majority of dental provisions are for private treatment to adults.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the roads around the practice and in local public car parks.

The dental team includes two dentists, two dental nurses and a trainee dental nurse, four dental hygienists, a practice manager and two receptionists. The practice has two 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 Haynes Road Dental Practice was the principal dentist.

On the day of inspection we collected 59 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists, one dental nurse and one trainee dental nurse, 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 and Friday 9.00am – 1.00pm and 2.00pm – 5.00pm
• Tuesday 10.00am – 1.00pm and 2.00pm – 7.00pm
• Wednesday 8.00am – 1.00pm
• Thursday 9.00am – 1.00pm and 2.00pm – 6.00pm
• The practice is closed at weekends.
• Out of hours information is displayed on the website and via the telephone answering service.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures except for the occasional agency staff.
• 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice recruitment procedures to ensure that appropriate checks are completed prior to agency staff commencing work at the practice.

• Review the practice recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice. For example ensuring a Disclosure and Barring Service (DBS) check is completed for the practice and not being reliant on previous DBS check.
• Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective. For example with regard to fire awareness training and staff confidence and competence.
• Review the radiation protection file to ensure all relevant details are present and recorded correctly.
• Review the practice procedures for patient referrals and follow up to ensure referral is acted upon.
• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going monitoring, supervision and appraisal of all staff.
• Review the Accessible Information Standard regarding the availability of interpreter services, a hearing loop and large print or braille provision of documents.