We carried out this announced inspection on 10 April 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

Ongar Road Dental Practice is in Brentwood and provides 80% NHS and 20% private treatment to patients of all ages.

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

The dental team includes seven dentists, one specialist orthodontist, two orthodontist therapists, three hygienists, eight dental nurses including one dental nurse/practice manager, three trainee dental nurses and one temporary trainee dental nurse, three receptionists and a practice management team. The practice has eight 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 Ongar Road Dental Practice was the principal dentist.

On the day of inspection we collected 97 CQC comment cards filled in by patients and spoke with four other patients.

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

The practice is open: Monday to Thursday from 8am to 5.30pm, Friday from 8am to 4pm.

Our key findings were:

• The practice appeared clean and well maintained.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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.
• Patients were wholly positive and happy with the quality of their treatment and the staff who delivered it.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• Staff had received training appropriate to their roles and were supported in their continuing professional development by the principal dentist and practice manager.
• The appointment system met patients’ needs.
• The practice had effective leadership and a 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 systems for checking and monitoring electrical equipment taking into account current national guidance and ensure that all equipment is well maintained.
• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ (In particular the decontamination area and the location of clean and dirty areas in the treatment rooms).
• Review the practice’s protocols to ensure audits of various aspects of the service, such as radiography and infection prevention and control are undertaken at regular intervals to improve the quality of service. Practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

We found that people had given their consent prior to treatment being given. People told us that they were provided with sufficient information which included costs, and were given time to think about their options. One person told us “I always have felt happy and in control of what is happening, and they never do anything without my agreement first.”

We saw that treatment plans were developed with the person and assessed any risks associated with the treatment. One person told us, “I have no concerns about this place, it is excellent. My relative had problems at their dentist so I recommended them here and they also love it now.”

The practice operated effective decontamination and infection control methods according to relevant guidance. One person who used the service said, “I have never seen any dirty equipment lying around and when I sit in the chair the room is spotless.”

Staff received appropriate support however people did not receive an annual appraisal of their performance that allowed their development to be planned. One staff member told us, “I love it here, it is a nice atmosphere and we all work well together.”

The provider had an effective system to regularly assess and monitor the quality of service that people receive.