We carried out this announced inspection on 4 December 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

J G Plummer and Associates is a family run business which own and manage 11 practices in the Norfolk and Suffolk area. The Wymondham branch provides mostly NHS treatments to adults and children. The dental team includes 15 dentists, 21 dental nurses and three receptionists. An orthodontist specialist visits once a month. There are five surgeries and the practice opens from 8.30 am to 5 pm Monday to Friday.

There is level access for people who use wheelchairs and those with pushchairs.

As a condition of registration, the practice 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 is one of the partners, who is also a dentist at the practice.

On the day of inspection, we collected 32 CQC comment cards filled in by patients and spoke with two other patients. We spoke with two dentists, two dental nurses, administrative staff and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice appeared clean and well maintained.
• Staff knew how to deal with emergencies, and appropriate medicines and life-saving equipment were available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Patients’ care and treatment was provided in line with current guidelines.
• The practice provided good preventive care and supported patients to ensure better oral health.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice took complaints and concerns seriously and responded to them appropriately to improve the quality of care.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted upon.
• The practice’s staff recruitment procedures were not robust.
• Infection control procedures needed to be strengthened to ensure that cement was removed from instruments, and that instruments were rinsed properly.
• Patients’ confidential information was not held securely. This was an issue we had raised at previous inspections which the provider had failed to address.

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

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.

• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.