We carried out this announced inspection on 25 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

Kimberley Family Dental Care is located in premises in the village of Kimberley to the west of Nottingham. The practice provides mainly NHS (99%) dental treatment to patients of all ages.

There is ramped access at the rear of the practice which enables patients who use a wheelchair or have large pushchairs to access the premises. The practice has a small car park to the rear of the premises or there is roadside parking available in the local area.

The dental team includes two dentists; two qualified dental nurses including the practice manager; and one trainee dental nurse. The practice has three treatment rooms, one of which is on the ground floor.

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 Kimberley Family Dental Care is the principal dentist.

On the day of inspection we collected 38 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses, and the acting practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday: 9 am to 6 pm; Tuesday 9 am to 5 pm; Wednesday 9 am to 6 pm; Thursday: 9 am to 5 pm; and Friday: 9 am to 2 pm.

Our key findings were:

• The practice was clean and well maintained.
• 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 suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The records of products governed by Control of Substances Hazardous to Health (COSHH) 2002 Regulations were not complete.
• The practice had thorough staff recruitment procedures.
• 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 appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice did not have an induction hearing loop.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review the practice's policy for products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and there are manufacturer’s safety data sheets for each item. 

• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. People told us that their treatments were discussed with them. We also observed the dentist speaking to people in a respectful and kind manner, involving them in their care and treatment by clearly explaining their interventions and recommended treatment going forward. People were relaxed and interacted easily with the dentist and other staff in the service.

During our inspection we spoke with four people who used the service. They told us they were happy with the service they received. One person said, "I don't mind coming to the dentist anymore."

We looked at the records for five people who used the service. We found these detailed people's treatment plans, visit dates and treatments received, signed treatment plans and medical history checks at each visit.

We spoke with two members of staff who said they were well supported and had received a range of training appropriate for their role.

We saw that the service had all the appropriate policies in place to effectively manage infection control. We found that although the service's decontamination room did not comply with the recommended best practice of the Department of Health, the service was following good infection control practices.

We reviewed the service's quality monitoring processes and found that these were robust and fit for purpose.