We carried out an announced comprehensive inspection on 17 February 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

IDH Wellington is located in the town of Wellington, Somerset. The practice provides primary dental care services. The practice provides NHS and private patient care. There are four dental surgeries, with three currently in use due to a dentist vacancy. There is one ground floor surgery for patients who have mobility restrictions and level access from a lane at the back of the practice for wheelchair access. Approximately 8,300 patients are registered and the practice provides dental care to both adults and children.

The staff structure of the practice consists of two dentists and a dentist who is in their foundation year after qualifying, this involves the dentist being supervised and mentored by one of the qualified dentists at the practice, two dental hygienists, two qualified dental nurses, two trainee dental nurses, a practice manager, three receptionists and a cleaner. The practice is a training practice for dentists in their foundation years after graduating.

The practice is open on Mondays, Tuesdays, Wednesdays and Fridays from 8am – 6pm and on Thursdays from 8am – 5pm. There is an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 inspection took place over one day and was carried out by a CQC inspector who had remote access to a dental specialist advisor if required.

Forty eight patients provided feedback directly to CQC about the service. All were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received. However, a number of patients commented that there were some difficulties in getting non-urgent appointments at this busy practice and patients felt that there had been a high turnover of dentists; patients said they preferred consistency with who they saw.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• There were effective systems in place to reduce and minimise the risk and spread of infection.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from the practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• Appointment text/phone reminders were available on request 48 hours prior to appointments.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continued professional development by the management team.
• Staff we spoke with felt supported by the management team and were committed to providing a quality service to their patients.

There was one area where the provider could make improvements and should:

• Review the systems for the clinical audit cycle to ensure that audits are meaningful, and inspire improvements and learning.

This was the practice’s first inspection since dental services were required to register with the Care Quality Commission. The practice had both adults and children registered. We visited the practice on one day, during the practice’s normal opening hours.

During our inspection we checked and were assured that people using the dental practice had access to examinations in private. We met and spoke with seven staff and checked records. We found that patient and staff records were completed well. Records demonstrated that people were consulted about advised treatments and that on-going dental care was monitored. We inspected the premises and were satisfied that people received safe and effective treatment in a clean environment.

Following our inspection we contacted, with their permission, people who had attended the practice the day of our visit. We asked people how they were involved in their treatment planning and whether they were invited to give feedback about their experiences. One person said they had not been asked but the other person said they had previously completed a survey for the provider. We received two responses to questionnaires we sent to nine people via email. Both people expressed overall satisfaction with the practice and treatment they had received.