We carried out this announced inspection on 3 August 2017 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 not provide any information for us to take 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

Pentwyn Dental Surgery is in West Bromwich and provides NHS and private treatment to patients of all ages.

There is a treatment room on the ground floor and this accommodates patients with wheelchairs and pushchairs. However, there is no level access to the practice as there are a few steps leading to the main entrance. Car parking spaces are available near the practice.

The dental team includes two dentists, five dental nurses (one of whom is a trainee), one dental hygienist therapist, one receptionist and a practice manager. The dental nurses also carry out reception duties. The practice is in the process of recruiting another dentist. The practice has three treatment rooms.

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 collected 47 CQC comment cards filled in by patients and spoke with one other patient. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, two dental nurses, one receptionist 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 9am – 5:30pm

Tuesday 9am – 8pm

Wednesday 9am – 5:30pm

Thursday 9am – 5:30pm

Friday 8:30am – 4pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance. Some improvements were required.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available but improvements were required with checks undertaken.
• 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 staff recruitment procedures but improvements were required to ensure a robust system was in place.
• 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 availability of medicines and equipment to manage medical emergencies during domiciliary visits, giving due regard to guidelines issued by the Resuscitation Council (UK) and the General Dental Council (GDC) standards for the dental team. Equipment checks should be in line with current guidance.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff. .
• Review the practice's current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and, where applicable, learning points are documented and shared with all relevant staff.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.
• Review the flooring, work surfaces and upholstery in clinical areas and consider replacing them with a smooth impervious covering as soon as any defects are identified.

During our inspection we spoke with the two dentists, a dental nurse, the practice manager (trainee) and we briefly spoke with one person who was waiting to receive treatment. We also observed one person receive treatment and spoke to them about their experience. We looked at the records for ten people who had used the service.

Following our visit we spoke with four people over the telephone so that we could get their views of the quality of service provided. All the people we spoke with were very positive about their experiences. They felt they were given enough information about their treatment options and were always asked about their medical history. One person told us: “From the first appointment they explained the cost and the treatment involved. They gave me three options that were best for me”. Another person we spoke to said: “I had to do a medical questionnaire”.

There were regular checks to ensure equipment’s and emergency medications were in working order.

There were infection prevention procedures in place to minimise the risk of infection. Decontamination procedures were followed to ensure instruments were being hygienically cleaned.

Staff had received appropriate training and development to enable them to deliver treatment to people safely and to an appropriate standard.

There were procedures in place to monitor quality of service and identify improvements where necessary.