We carried out this announced inspection on 24 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

The practice is well-established and located in the small village of Ormesby, close to Great Yarmouth. It provides both NHS and private treatment to adults and children, and serves about 4,400 patients. The dental team includes five dentists, three dental nurses, one dental hygienist, and two receptionists.

There are two treatment rooms and the practice opens from 8.30am to 5pm Monday to Friday.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available immediately outside.

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 the practice is one of the dentists.

On the day of inspection we collected 31 CQC comment cards filled in by patients and spoke with three other patients.

During the inspection we spoke with one dentist, 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 effective systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• Risk assessments were robust and action was taken to protect staff and patients.

• Patients received their care and treatment from well supported staff, who enjoyed their work

• The practice had thorough staff recruitment procedures.

• 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 practice had strong, effective leadership and a culture of continuous audit and improvement.

• The practice asked staff and patients for feedback about the services they provided. 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 management of patients with periodontal disease giving due regard to guidelines issued by the British Society of Periodontology.

• Review the security of prescriptions in the practice and ensure there are systems in place to monitor and track their use.

• Review the practice’s protocols for the use of rubber dam for root canal treatment, giving due regard to guidelines issued by the British Endodontic Society

• Review the practice’s complaint handling procedures to ensure that all patient feedback is collected and responded to.