We carried out this announced inspection on 19 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.

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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Mere Dental Practice is in Mere 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 are available near the practice. There are no designated bays for blue badge holders.

The dental team includes three dentists, three dental nurses and one trainee dental nurse, two dental hygienists and one receptionist. The practice has three treatment rooms.

The practice is owned by a partnership 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 Mere Dental Practice is one of the principal dentists.

On the day of inspection we received feedback about the practice from 35 people .

During the inspection we spoke with three dentists, two dental nurses, the trainee dental nurse, one receptionist and the registered manager who is also one of the principal dentists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday – Thursday 08.45am - 5.30pm
• Friday 08.45am – 5.00pm
• Out of hour’s information displayed on website and via telephone answering service.
• At present the practice does not do a late evening, instead out of hours appointments are done by prior approval booking with the practice. This applies solely for private patients.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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 provider 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 provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice waste handling and storage to ensure waste awaiting collection is secured and disposed of in compliance with the relevant regulations; taking into account the guidance issued in the Health Technical Memorandum 07-01.

• Review the practice protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development.

• Review the current staffing arrangements to ensure all dental care professionals, including hygienists, 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.
• Review the practice systems and processes to follow up referrals to other practitioners.