We carried out this announced inspection on 13 June 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 CQC registration 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

Lyme Bay Dental and Implant Clinic is in Lyme Regis and provides private treatment to patients of all ages.

There is access for people who use wheelchairs and those with pushchairs, with staff assistance. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes four dentists, four dental nurses, three trainee dental nurses, two dental hygienists, one treatment coordinator, one practice manager and one receptionist. The practice has three 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 Lyme Bay Dental and Implant Clinic was the practice manager.

On the day of inspection we collected 23 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with two dentists, three dental nurses, two trainee dental nurses, one dental hygienist, the receptionist, the company compliance facilitator 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 to Friday 8am to 5pm.

Saturday 8am to 1pm once a month.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were mostly 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 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 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 continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

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

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.

We carried out an announced comprehensive inspection on 19 June 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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.

The practice was located at Temple House 63 Broad Street Lyme Regis Dorset DT7 3QF. Opening hours were between 8.15am and 5pm. Treatments offered included preventative and restorative care, implants and dental hygiene. The practice provided care for private patients only.

Our key findings were:

• There were effective systems in place in the areas of clinical waste control and management of medical emergencies.
• The staffing levels were appropriate for the provision of care and treatment.
• The practice provided evidence based dental care which was focussed on the needs of their patients. We saw examples of effective collaborative team working.
• The staff were up-to-date with current guidance and received professional development appropriate to their role and learning needs.
• Staff, who were registered with the General Dental Council (GDC), had frequent continuing professional development (CPD) and were meeting the requirements of their professional registration.
• Patients’ dental care records we reviewed provided a full and accurate account of the care and treatment they had received.
• Patients felt they were listened to, treated with respect and were involved with the discussion of their treatment options which included risks, benefits and costs.
• We observed the staff to be caring, compassionate and committed to their work.

• The leadership, management and governance of the organisation assured the delivery of high-quality, patient centred treatment and care, supported learning and innovation, and promoted an open and fair culture.