We carried out this announced inspection on 16 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 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

Karedent is in Droitwich and provides private treatment to adults and children.

There is a portable ramp to facilitate access for people who use wheelchairs and pushchairs. Car parking spaces are available in the dedicated practice car park at the rear of the building.

The dental team includes three dentists, two dental nurses, one sterilisation technician, one dental hygienist, one dental hygiene therapist, two receptionists and a practice manager. The practice has five treatment rooms.

The practice is owned by a company and as a condition of registration they 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 Karedent was the practice manager.

On the day of inspection we collected 37 CQC comment cards filled in by patients and looked at the most recent patient survey undertaken in May 2018. Without exception, patients were positive about the quality of the service provided by the practice. They gave examples of the positive experiences they had at the practice and told us the practice team were professional, friendly and always put them at ease.

During the inspection we spoke with three dentists, two dental nurses, one sterilisation technician, one dental hygiene therapist, one receptionist 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: 9am to 6.30pm

Tuesday: 8.30am to 5pm

Wednesday: 8.30am to 5pm

Thursday: 8.30am to 5pm

Friday: 8.30am to 5pm

Saturday: 9am to 1pm

Our key findings were:

• We noted that the practice ethos was to provide quality caring, gentle dental care and to treat and care for patients as the team would for their own families.
• Strong and effective leadership was provided by the principal dentist and empowered practice manager. Staff felt involved and supported and informed us this was a good place to work.
• The practice appeared clean and well maintained. An employed cleaner was responsible for the day to day cleaning.
• The practice 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 had an established process for reporting and recording significant events and accidents to ensure they investigated these and took remedial action.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Safeguarding contact details were available in every treatment room.
• The practice had thorough staff recruitment procedures and a supporting recruitment policy.
• 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. Patients could access treatment and emergency care when required.
• The practice asked staff and patients for feedback about the services they provided. Information from 37 completed Care Quality Commission (CQC) comment cards gave us an extremely positive picture of a professional, friendly, caring and high quality service.
• 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’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular ensuring all referrals are logged, air conditioning units are serviced in line with manufacturer’s guidance and a risk assessment is completed for Hepatitis B non-responders.

The practice had one senior dentist, two part time associate dentists, a practice manager, two dental nurses, a sterilisation nurse and a receptionist. Appointments could also be made with the full time or one of the two part time dental hygienists.

This inspection was discussed and arranged with the practice a few days in advance. This was to ensure that we had time to see and speak with staff working at the practice. As part of our inspection we spoke with the practice manager, a dental nurse and the sterilisation nurse. We did not have the opportunity to talk with people who were attending the practice. We later spoke with six people by telephone who had recently attended the practice.

The information provided to us indicated that people were happy with the quality of treatment they received. They felt they had been given enough information about their treatment options and the relevant fees. One person said, "All the options and fees are fully talked about before treatment starts." Another person told us, "Only had positive experiences at the practice."

We saw that the practice was very clean so that the risks of infection were minimised. There was a system in place for people to make complaints if they were not happy with any aspect of the service. We noted that the practice had not received any formal complaints during the last 12 months.