We carried out this announced inspection on 15 August 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

Marlborough Dental is in Coalville, Leicestershire and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. There are no car parking facilities available on site for patient use. Public car parking is accessible directly outside the practice for limited stay and there are a number of local car parks within close vicinity to the practice. These include parking spaces for disabled patients who are blue badge holders.

The dental team includes five dentists (including a foundation dentist), a specialist orthodontist, five dental nurses, two apprentice nurses, a dental therapist and a practice manager (who is also qualified as a dental nurse). The practice also employs two receptionists. The practice has four treatment rooms; two of these are 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 Marlborough Dental is one of the principal dentists.

The practice is an approved training practice for dentists new to general dental practice. The practice has been a training practice for the past five years and the two principal dentists are joint trainers. The current trainee has been in post 11 months at the time of our inspection.

On the day of inspection we collected 11 CQC comment cards filled in by patients. This information gave us a positive view of the practice. We did not receive any negative feedback about the practice.

During the inspection we spoke with two principal dentists, an associate dentist, the foundation dentist, the specialist orthodontist, a dental nurse, the practice manager and two receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open Monday, Wednesday, Thursday 9am to 5.30pm, Tuesday 9am to 7pm and Friday 9am to 4pm.

Our key findings were:

• The practice ethos included the promotion of good oral health to all their patients and the provision of high quality dental care. The objectives included understanding patients’ needs and involving them in decisions about their care.

• Effective leadership from the provider and practice management was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and lifesaving 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 of untoward incidents and shared learning when they 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 these into account when delivering the service.
• 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.
• Governance arrangements were embedded within the practice.

We spoke with three people who were using the service during our visit. They told us that they had been involved in deciding what treatment they received and that they were happy with how they had been looked after during their visit. One person told us: It’s lovely, they’re very friendly and they treat the kids really well.”

There were systems in place to reduce the risk and spread of infection. Infection prevention and decontamination policies were in place and one of the dental nurses demonstrated the decontamination process for instruments used during surgery. The policies were up to date and were made available to all the staff and the dental nurse followed the decontamination process in line with the recommended guidelines set by the Department of Health.

A comprehensive auditing system was in place to monitor and assess the quality of the service being provided. This ensured that people who were using the service were being provided with the best service possible.

People told us that they found the practice to be clean and tidy and confirmed that the dentists, orthodontist and the dental nurses wore protective clothing when providing treatment. One person explained: “They wear gloves and they give me glasses to wear.

An appropriate recruitment process was in place and all the staff working at the practice were supported to attend relevant training to enhance their skills within their role.