We carried out this announced inspection on 15 April 2019 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

Meavy Way Dental Practice is in Plymouth and provides NHS and private treatment to adults and children.

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

The dental team includes eight dentists, seven dental nurses, two trainee dental nurses, two dental hygienists, a practice manager, a trainee practice manager and a receptionist (all dental nurses also act as reception staff). The practice has seven treatment rooms.

The practice is owned by an individual who was the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 31 CQC comment cards filled in by patients and spoke with two other patients. This gave us a positive view of the practice.

During the inspection we spoke with five dentists, five dental nurses, one trainee dental nurse, one dental hygienist, one receptionist, the practice manager and trainee 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 8.30am – 5.30pm.

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 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 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 current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council. Where immediate chair side support is not provided risk assessments should be considered.

• Review procedures and policies for any resumption of conscious sedation services, taking into account guidelines ‘Conscious Sedation in Dentistry,’ published by SDCEP (2017).

We spoke with four people receiving treatment from different dentists at this practice. People described their dentist as "very good", "on the ball", "put you at ease", dentist is really good". Other comments about the practice included "we've been pleased", big practice they are very nice here". Everyone confirmed appointments were available to suit them. People told us everything was explained and the dentists discussed treatment options. Everyone said they were asked for their consent and involved in their treatment plan.

People's treatment needs were assessed carefully. Treatment was provided effectively by experienced and qualified staff. There were systems in place to provide care in the event of a medical emergency. Medicines were managed apropriately to keep people safe.

People who used this service and staff were protected from identifiable risks of acquiring an infection because the operation of systems provided to prevent the spread of infections was designed in accordance with the guidance from the Department of Health primary care dental practice.

Staff were qualified and had the skills and experience to carry out their jobs. They were registered with relevant professional bodies which meant they were able to carry out their respective jobs. The quality of the service provided was audited and monitored by the staff, the provider and externally by other regulatory bodies.

We found the provider managed complaints appropriately and in a timely manner.

When we visited Meavy Way Dental Practice we met with the service provider, the practice manager, two of the dentists and three other staff on duty. We spoke with two people who were visiting for examination or treatment, and spoke by phone with six other people who used the service.

People who spoke with us had been well satisfied with the service overall. “They’re excellent,” said one person. “I can’t praise them enough. The dentist explains everything, and the reception staff are polite and helpful.”

People told us they had been given written treatment plans, with advice about how much their treatment would cost.

People said they could get appointments quickly, and rarely had to wait long when they came for their appointment. People appreciated receiving text messages to remind them when their appointment was due.

We looked round the practice and saw how the premises and the equipment were kept clean and hygienic. We looked at documents that showed how well the regular checks were carried out to demonstrate that all systems worked efficiently.

We found that the arrangements in place to store medication were not in accordance with professional guidance, which could potentially put people at risk of unsafe use of medicines.