We carried out this announced inspection on 14 November 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 and a second CQC inspector.

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

Lander Dentistry is in Truro and provides private treatment to mainly adults.

There is ramp access for people who use wheelchairs and those with pushchairs (although the practice is not fully accessible). Car parking spaces are available near the practice.

The dental team includes three dentists, five dental nurses, one trainee dental nurse, two dental hygienists, a new patient coordinator, a practice manager and reception staff. The practice has four 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 Lander Dentistry was the practice manager.

On the day of inspection we collected 27 CQC comment cards filled in by patients. This gave us a positive view of the practice.

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

The practice is open: Mon – Thu 7.45am – 5pm (appointments 8.15am – 4pm). Fri 7.45am – 5pm (appointments 8.15am – 12.30pm).

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of improvement.
• The practice asked patients for feedback about the services they provided.
• 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 sharps written procedures to ensure the practice is following the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010 and associated Accessible Information Standards.

• Review the practice’s annual audit cycle with particular consideration to the inclusion of patient record card audit and antibiotic stewardship, to improve the quality of the service.