We carried out this announced inspection on 4 June 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

Portmore Weybridge LLP is in Weybridge and provides private treatment to adults and children.

The dental practice is situated on the first floor. Access is via a set of stairs and lift if needed. The practice has level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including two for blue badge holders, are available near the practice.

The dental team includes four dentists, five dental nurses, two trainee dental nurses, one dental hygienist, two dental hygiene therapists and four receptionists. The practice has eight treatment rooms.

The practice is owned by a limited liability partnership (LLP) 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 Portmore Weybridge LLP was the practice manager.

On the day of inspection we collected 16 CQC comment cards filled in by patients

During the inspection we spoke with three dentists, three dental nurses, one receptionist and the practice manager (registered manager). We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Mon/Wed/Thurs – 8am -5pm

Tues -8am -7pm

Fri – 8am-4pm

Sat – by appointment

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s protocols to ensure audits of patient notes and antimicrobial prescribing and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated. post inspection the provider confirmed this was being addressed. 

We carried out an inspection at Portmore Dental to look at the care and treatment provided to patients who used the service.

As part of our inspection we spoke with three patients and, with their permission, observed one treatment session. We spoke with two dental practitioners and two staff, as well as the manager and reviewed ten patient's records. In addition, we collected five survey responses from patients who were attending appointments.

The patients we spoke with and the results of the surveys showed us that patients were happy with the service. They described the practice as “Really approachable.” They told us that staff asked for their consent in advance of starting treatment. Patients were aware of their treatment plans and had been given options about the treatment they received. We found however, that patients updated medical history was not always checked or recorded at each appointment and that the practice did not have appropriate equipment in place in the case of an emergency.

We observed that the premises were clean and that staff were seen to wear gloves and masks when they carried out treatments. However, we found that the practice did not have robust processes in place which ensured sterilised equipment was date checked.

We saw that patients were given information that related to how to make a complaint should they need to.