We carried out this announced inspection on 23 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

Norfolk Dental Specialists is a well-established practice in Norwich city centre that offers private treatment to about 3,000 adults. The practice specialises in periodontics, endodontics, implants and dental hygiene.

The dental team includes six dentists, eight dental nurses, four hygienists, a receptionist and a practice manager. There are four treatment rooms. There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available.

The practice opens from 8.30 am to 5pm Mondays, Wednesday and Fridays, and on Tuesdays and Thursdays from 8.30 am to 6pm. It also opens on Saturdays from 9am to 3pm.

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 is the practice manager.

On the day of inspection, we collected 30 CQC comment cards filled in by patients and spoke with two other patients. We spoke with two dentists, two dental nurses, the receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.
• Patients received their care and treatment from well supported staff, who enjoyed their work.
• Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.
• The practice provided good preventive care and supported patients to ensure better oral health.
• Complaints were well managed and the practice responded empathetically to patients’ concerns.
• The practice had effective leadership and a culture of continuous audit and improvement.

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

• Review management systems to ensure an accurate account of all medicines held in the practice is kept and that medicines labels contain information about the practice’s address.

• Review the storage of dental card records to ensure they are held securely.

  
  

During our inspection of the service we spoke briefly with four people, two of whom were waiting for their appointments and two visitors. The two people waiting for their appointment had been attending the dentist surgery after being referred by their own dentist for specialised treatment.

One person told us "I don't wait for long for my appointment, and I always get asked if I would like a drink while I am waiting. The dentist keeps me informed about my treatment and how long it will take".

All four people told us the dentist and the dental nurses were very friendly and patient with them, as well was the receptionist.

Those we spoke with had no concerns and felt the surgery was well run.

One person told us "It is very reassuring to have a folder full of positive comments from other patients to read".