We carried out this announced inspection on 11 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. A CQC inspector who was supported by a specialist dental adviser led the inspection.

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

Kinnersley House is a well-established dental practice that provides both private and NHS treatment to patients of all ages. The dental team consists of four dentists, four dental nurses, a dental hygienist and a practice manager. The practice has four treatment rooms and is open on Mondays to Thursdays from 8.30am to 5.30pm, and on Fridays from 8.30am to 4.30pm. In addition to this, it opens until 6.30pm on alternate Fridays, and from 8.30am to 1.30pm on alternate Saturdays.

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

The principal dentist, who is also the owner, is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

During the inspection we spoke with two dentists, two dental nurses, the receptionist and the practice manager. We looked at the practice’s policies and procedures, and other records about how the service was managed. We collected 50 comment cards filled in by patients prior to our inspection. We also spoke with another three patients during our inspection.

Our key findings were:

• We received many very positive comments from patients about the dental care they received and the staff who delivered it.

• The practice had suitable safeguarding processes and staff knew their responsibilities for protecting adults and children.

• Members of the dental team were up-to-date with their continuing professional development and supported to meet the requirements of their professional registration.

• Staff felt well supported by the practice owner, and there were regular practice meetings. The practice listened to its patients and staff and acted upon their feedback.

• The appointment system had been extended to better meet patients’ needs.

• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.

• There was no system in place to ensure that untoward events were analysed and used as a tool to prevent their reoccurrence.

• Systems to ensure the safe recruitment of staff were not robust, as essential pre-employment checks were not always completed.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.

• Review audit protocols to ensure learning points are documented and shared with all relevant staff and that the resulting improvements can be demonstrated as part of the audit process.

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

During our review we spoke with two people who used the service. They were positive about the care and treatment they received. One person told us they had been “Very satisfied” and that “Reception and nurses are helpful and considerate.” One person said there had been a number of staff changes recently but this had not affected their care.

We found that dental care was provided according to people's assessed needs. We saw that the waiting area had a range of information about dental care and oral hygiene.

We spoke with a dentist, two dental nurses and the practice manager during the inspection. We also spoke with four people who used the service. They told us they were happy with the service. One person said, "The staff are all very supportive here." People told us that the dentist explained their care and treatment to them in a way they could understand.

We saw that equipment, including infection control equipment, was properly maintained and serviced. We saw there were appropriate infection control procedures.

We found that staff were supported, trained and experienced in their roles. We saw that the service had an effective complaints procedure in place and audits in place to monitor its quality.