We carried out this announced inspection on 8 January 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.

We told Healthwatch that we were inspecting the practice. They did not provide any information.

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

Pemros Dental Practice is in Plymouth and provides private treatment to patients to mostly adult patients.

There is level access for people who use wheelchairs and pushchairs. There are two treatment rooms on the ground floor, although the practice is not fully accessible as the patient toilet is on the first floor, accessed via stairs. Car parking spaces are available on the road nearby the practice. There is a small private car park at the rear of the practice.

The dental team includes one dentist, two dental hygienists, two dental nurses, one dental nurse/receptionist, one practice manager (who is also a dental nurse), one receptionist and one cleaner. The practice has three treatment rooms.

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 Pemros Dental Practice was the principal dentist.

On the day of inspection we collected 25 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist, practice manager/dental nurse, an additional dental nurse (who was the infection control lead at the practice), one hygienist and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday 8:30am – 6pm. Fridays 8:30am – 2pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 appointment system met patients’ needs.
• The practice had effective leadership. 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.

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

• Review the practice’s protocols for conscious sedation, taking into account guidelines published in 2017 by The Scottish Dental Clinical Effectiveness Programme (SDCEP), now recommended by faculties of the Royal Colleges in the UK.

• Review practice's recruitment procedures to ensure that appropriate reference checks are completed and recorded prior to new staff commencing employment at the practice.

During our visit we met with four people who were visiting for treatment or examination and we also spoke with four other people by phone. We met with the dentist and four staff on duty.

People told us that “It is lovely and clean and the staff are very friendly.”

People were very pleased with the dentist’s ability to put them at ease. “He is helpful and kind and the whole team reflects this,” said one person. Another said, “He is very good with our children and makes them relax.”

People said that they had been asked regularly for updates on their medical history and that the dentist checked their oral health at each visit.

People confirmed that the dentist explained fully his diagnosis and their treatment options. “We have had quite a bit of talk about my present treatment”, one person told us. “He does explain fully. He gives the air of confidence, he listens.”

We saw that staff had systems to check that the machines worked properly and methods of checking that they completed routine tasks on time. There were also checks on the quality of the service provided, showing continual improvement.

The premises were accessible throughout the ground floor with a gentle ramp at the front door, and good surfaces to all floors. There were two treatment rooms on the ground floor, one used by the dentist and the other by the hygienist. There was another upstairs, unused at the time of this visit. The toilet was upstairs.