We carried out this announced inspection on 9 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 the NHS England area team that we were inspecting the practice. They did provide information which we took into account.

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

Penny Hill Dental Care is in Bagshot and provides NHS and private treatment to patients of all ages.

There is access to the building for people who use wheelchairs and pushchairs. Car parking spaces are available at the practice.

The dental team includes six dentists, four dental nurses, two trainee dental nurses, two dental hygienists, and 2 receptionists. The practice has 3 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 Penny Hill Dental Care was the principal dentist.

On the day of inspection we collected 34 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a mostly positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses, 1 receptionists 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 9.00 to 17.00.

Saturday 09.00 to 15.00 (for private patients)

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 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.
• 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 protocol for completing accurate, complete and detailed records relating to employment of staff. This includes making appropriate notes of verbal reference taken and ensuring recruitment checks, including references, are suitably obtained and recorded.
• Review availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the suitability of the premises and ensure all parts were fit for the purpose for which they are being used.
• Review the fire and health and safety risk assessments to ensure all identified risks are monitored and mitigated and all actions are completed promptly.
• Review its responsibilities to respond to meet the needs of patients with disability and the requirements of the Equality Act 2010.   

We found that the provider was compliant with all the outcomes inspected.

All of the patients we spoke with told us that the practice was clean and staff wore protective equipment to minimise the risk of cross infection.

Patients’ all told us that they were treated with dignity and respect. One patient said, "The staffs are so polite.”

We saw that patients were given written treatment plans so that they understood their treatment options and they had signed consent forms to agree to the treatment.

Staff told us that they were fully supported by the provider in all aspects of their professional lives.

We found the clinical and other practice records fit for purpose and patients’ could be confident that their persona information was stored securely.