We spoke with patients, all were confident that their dental needs were met and that they were always consulted before treatment was given. Comments such as "Very helpful" and "Always reassuring" were made.

Staff told us that their training needs were met and records showed that the provider discussed staff’s training needs with them.

We observed during the inspection, that arrangements were in place to prevent the spread of infection.

We also saw records that showed each patient had a plan in place to meet their individual treatment needs.

Checks (audits) showed the provider had checked the quality of the service in order to protect patients.

We carried out this announced inspection on 27 July 2017 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

Kew Dental Surgery is in a residential suburb of Southport and provides dental care and treatment to adults and children on an NHS or privately funded basis.

There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs. Car parking is available at the practice.

The dental team includes two dentists and three dental nurses, one of whom is a trainee. The dental nurses also carry out reception duties. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

We received feedback from 12 people during the inspection about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to the principal dentist and the dental nurses. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 8.30am to 4.45pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• Staff knew how to deal with emergencies. We observed that one of the recommended medical emergency medicines was not available.
• The practice had systems in place to help them manage risk, but risks were not all reduced as far as reasonably practicable.
• The practice had staff recruitment procedures in place, but some of the pre-employment checks were not carried out.

There were areas where the provider could make improvements and should:

• Review the availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council standards for the dental team, specifically in relation to midazolam and the automated external defibrillator.
• Review the practice's recruitment policy and procedures to ensure references and evidence of qualifications for staff are requested and recorded suitably.
• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from undertaking of the regulated activities, to ensure they are operating effectively.