We carried out this announced inspection on 20 September 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 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

No 65 The Dental Surgery is in Wadebridge and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs at the rear of the premises. Car parking spaces are available near the practice.

The dental team includes three dentists, four dental nurses, two trainee dental nurses, two dental hygienists, two dental therapists, a practice manager (who is also a qualified dental nurse), two receptionists and a cleaner. 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 No 65 The Dental Surgery was the practice manager.

On the day of inspection we collected 20 CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses, one trainee dental nurse, one dental hygienist, one receptionists 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 8.30am – 12.50pm. 2pm – 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.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.

• Review systems for monitoring the effectiveness of checks on emergency equipment and medicines.

• Consider the development of a system to monitor antimicrobial prescribing through audit, in conjunction with the development of a practice sepsis policy.

• Consider the development of a comprehensive significant event/learning event reporting system to aid the practice in understanding risks and support future learning.

During this visit we met with six people using the service, two of whom had treatment with Dr Durnall. People told us they thought the service and the treatment they received was very good, that the dentist took care to check their health and current medication. This would ensure that any dental treatment would suit them.

They were pleased to be shown their X-ray pictures in order to understand what treatment they required and why it may be needed. One person said “They use thoroughly modern techniques,” another said “They embrace technology.”

People had paid tribute to ”the warmth and concern of all practice staff.”

We found that systems were in place that provided a safe and efficient service.

There were steps to the front door, but level access at the rear and a covered area where pushchairs and walking aids could be safely left. Once inside, there was level access throughout the practice.