We carried out this announced inspection on 12 December 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

Number 1 Dental Practice is in the Stoneygate area of Leicester, a short distance from the city centre. The practice provides mostly private dental treatment to both adults and children.

The practice has two treatment rooms, both of which are located on the ground floor. This is of benefit for people who use wheelchairs and those with pushchairs. There is car parking available at the practice, otherwise there is roadside parking in the area near the practice.

The dental team includes three dentists, one consultant oral surgeon, one consultant orthodontist, one specialist Registrar in periodontics, one dental hygiene therapist, five qualified dental nurses, one receptionist and personnel manager, one contracts manager, one accounts person, one cosmetic technician and a General Practitioner and Aesthetic Physician.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we received feedback from 28 patients.

During the inspection we spoke with the principal dentist and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday from 8am to 5.30pm, Tuesday from 7.30am to 5.30pm, Wednesday from 7.30am to 5pm, Thursday from 7.30am to 5pm, Friday: from 7.30am to 1pm. The practice is open on Saturday by appointment only and closed on Sunday.

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. Appropriate medicines and the recommended life-saving equipment were available.
• The practice had systems to help them manage risk.
• One dentist did not always use rubber dams during root canal treatments.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had the staff records required by schedule three of the Health and Social Care Act (2008).
• 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, although there was scope for improvement regarding audits completed in the practice.
• Staff felt involved and supported and worked well as a team.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.

As part of our inspection on this dental practice we spoke with three people who were visiting the dentist on the day of our inspection. We also spoke with five members of staff working at the practice, including the practice manager and the provider.

People who were visiting the dentist all told us they were very happy with the treatment and care they received. All three people had been visiting the practice for many years and described being well cared for and told us they had received appropriate treatment. One person told us: "It is really good. The best I've been to." Another person said: "Nothing's too much trouble for them. If you've got any problems they deal with it straight away."

Staff working at the practice told us they were adequately trained and qualified to carry out their roles and that they felt supported by the management. None of the staff we spoke with had any issues with the care and treatment delivered at the practice. One staff member said: "It's very enjoyable working here. The atmosphere is really friendly, the team is well established and they are very efficient. They know what they are doing."

We reviewed the policies and procedures in place at the practice in relation to the patient outcome areas we were looking at. We found that the practice was delivering safe and appropriate care and that they were consulting people about the way the practice was being run.