We carried out this unannounced inspection on 29 May 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

Nelson Road Dental Practice is in Gillingham and provides NHS and private treatment to patients of all ages.

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

The dental team includes eight dentists, three dental hygienists, four dental nurses, two student dental nurses and two receptionists. The practice has five 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 Nelson Road Dental Practice was the principal dentist.

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

The practice is open:

• Monday to Friday 9.00am – 5pm
• Late night opening for private appointments Tuesdays 5pm to 7pm
• Saturdays appointments available for private treatments once per month by appointment only.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice 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 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 suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular declutter the decontamination room and stock room paying particular attention to were the emergency medicines and equipment is stored.

We visited the practice on 20 March, due to concerns we had received about the presence of mould and flaking plasterwork in the reception area of the practice, which was allegedly affecting patient care. We found that action had been taken on a short term basis to ensure that the reception area was fit for purpose. Long term plans were in place to make sure that the occurance of damp in the reception area did not reoccur.

People told us that they were given clear information about the treatment choices available to them, so that they could come to a decision about which treatment would be best for them. One person told us, "He spoke through the options, costs and facts: the pros and cons. It is now my decision".

People told us that if they had any concerns that they felt confident to talk to staff or the dentist. Information about how to make a complaint was made available to people who use the service.

The practice had a number of systems in place to make sure that the service assessed and monitored its delivery of care. This included regularly asking people who use the service for their views and taking action to address any improvements that had been identified.