We carried out this announced inspection on 26 June 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 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

Highstreet Medical Dental is in Gillingham and provides NHS and private treatment to adults and children and offers bespoke care for children on the autism spectrum and those with ADHD.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including some for blue badge holders, are available near the practice.

The dental team includes 6 dentists, 4 dental nurses, one dental hygienist, one receptionist and two practice managers. The practice has six 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 Highstreet Medical Dental was the principal dentist.

On the day of inspection we collected 28 CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with four dentists, three dental nurses, one receptionist and one of the practice managers. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9am to 8pm

Thursday to Friday 9am to 6pm

Saturdays 9am to 1pm

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.
• 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 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.

We identified an area/s of notable practice.

The practice created bespoke care plans for children on the autism spectrum or with ADHD. This comprised of an initial visit to the building, so that the patient could familiarise themselves with the staff and environment. These visits would be repeated until the patient was comfortable. The practice used visual support tools to gather information and gave each patient a “passport” to fill in each time they visited which tracked their progress and treatments received. Feedback from parents and carers praised the care and time taken by staff and the service their relatives and children had received. All of the treatment rooms were identical in their colour scheme and set up. This was so that if one of the children or patients needed to be seen in another treatment room it would be familiar.