We carried out this announced inspection on 19 May 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

Kibworth Dental Practice is located in a village in South Leicestershire and provides private treatment to patients of all ages and NHS treatment to children only.

There is a small single step at the front entrance of the building. We were informed that this had not previously presented people with wheelchairs and pushchairs difficulties in entering the premises. The practice management told us that measures were however going to be undertaken to improve access arrangements. Car parking spaces, including those for patients with disabled badges are available in two public car parks within close proximity to the practice. There is also free on street parking outside the practice without restrictions on length of stay.

The dental team includes three dentists, six dental nurses, two dental nurse trainees and one dental hygienist. The dental nurses also share receptionist duties. The practice also employs a practice manager. The staff work between two practices owned by the provider. The practice we inspected has two treatment rooms.

The practice is owned by a company 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 Kibworth Dental Practice was the practice manager.

On the day of inspection we collected 14 CQC comment cards filled in by patients. This information gave us a very positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses 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, Tuesday, Wednesday and Friday from 8.30am to 5pm and Thursday from 8.30am to 7pm. The practice had recently started to open on the last Saturday in every month to accommodate any patients who may prefer weekend appointments. The practice told us they would review demand for the Saturday service option once it had been trialled.

Our key findings were:

• The practice ethos included the provision of high quality care including consultations, X-rays and dental treatments (including surgical) to improve the dental health of patients under their care. The practice told us they focussed on the prevention of dental disease by promoting good oral health to their patients.
• Effective leadership from practice management was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and life saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting and shared learning when untoward incidents occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice were aware of the needs of the local population and took most of these into account when delivering the service. We noted an area of improvement was required in relation to access arrangements for those with mobility problems. Responsive action was taken immediately by the practice.
• Patients had access to treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided. Information we obtained from 14 Care Quality Commission cards provided positive feedback. We did not receive any negative feedback.

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

• Review the practice’s arrangements for recording any action taken in relation to patient safety alerts issued (Medicines and Healthcare products Regulatory Agency, MHRA).
• Review the maintenance arrangements for building services.
• Organise refresher training for staff in the Mental Capacity Act 2005 and Gillick competence.

We spoke with two people who used the service. One person commented that staff

were, "They always tell me what they were going to do on the day so I know what to expect."

Another person we spoke to commented, "They tell me all about dental hygiene and that ."

We spoke with one person using the service about waiting times. They commented,"There is no waiting time, I come in early for a chat."

People said they were asked about their medical history and about any

dental problems. They said "I have been coming here for about 5 or 6 years and I think they are brilliant , there customer service is so good, every time I leave , I leave happy."