We carried out this announced inspection on 18 April 2017 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

North Street Dental Practice is in Lewes, East Sussex and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including those for patients with disabled badges, are available at the practice.

The dental team consists of one dentist, two dental nurses, three hygienists and four receptionists. The team is supported by a practice manager. The practice has two treatment rooms.

The practice is owned by a partnership of six dentists, including the provider, 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 North Street Dental Practice was the principal dentist.

On the day of inspection we collected 90 CQC comments cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, two dental nurses 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 until 4.45pm

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by the provider and an empowered practice manager.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• Infection control procedures were effective and the practice followed published guidance.
• The practice had effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a process in place for the reporting and shared learning when untoward incidents occurred in the practice.
• The dentist provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Conscious sedation was carried out in accordance with current guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the company.
• Staff we spoke with felt well supported by the provider and practice manager and were committed to providing a quality service to their patients.
• Information from 90 completed Care Quality Commission (CQC) comment cards gave us a positive picture of a friendly, caring, professional and high quality service.

During our inspection, we spoke with the provider, four dentists, two receptionists and three dental nurses. We spoke with six patients who all gave positive feedback about the care and treatment they had received. We observed staff members speaking to patients politely both at the practice and over the telephone and found they were happy to answer questions. We found records relating to patients were kept securely ensuring confidentiality. Patients told us they were given time to think before undergoing treatment.

We found people’s oral health needs were assessed and treatment was planned and delivered in line with their individual treatment plan. People's care and treatment reflected relevant research and guidance.

The prevention and control of infection and decontamination of instruments was effectively carried out in accordance with best practice guidance from the Department of Health in a room dedicated for that purpose only. We asked the patients we spoke with if they thought the practice was clean and tidy when they attended for treatment. One person told us, “Yes, the place is sparkling.”

We found staff were well supported in their professional development and encouraged to take part in additional training. Staff received effective supervision, training and appraisal. There were effective systems in place to regularly assess and monitor the quality of service in order to identify and manage risks.

People we spoke with told us that they were happy with the services provided. They told us that all treatment and discussions had taken place in private and that their dignity had been respected.

People told us that they had been provided with a treatment plan which detailed information about their treatment options and relevant costs. They told us that risks had been discussed with them and that they had been given time to think about their options prior to making a decision about their treatment.