We carried out this announced inspection on 8 September 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.

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

Pure Dental Studio is in Market Harborough, a town in South Leicestershire. It provides mostly NHS treatment to patients of all ages. There are a smaller number of patients registered to receive private treatment.

There is level access for people who use wheelchairs and pushchairs. There are some limited car parking spaces available at the rear of the practice for patient use. The practice advises patients who have mobility problems that they can also park at the front entrance of the premises.

The dental team includes five dentists, (including a foundation dentist), four dental nurses (two of these are trainee nurses), one dental hygienist, one dental hygienist therapist and one receptionist. The practice has four treatment rooms, two of which are located on the ground floor.

The practice is an approved training practice for dentists new to general dental practice. The practice has been a training practice for approximately seven years and one of the principal dentists is a trainer.

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 Pure Dental Studio was one of the principal dentists.

On the day of inspection we collected 31 CQC comment cards filled in by patients. This information gave us a positive view of the practice. We did not receive any negative feedback about the practice.

During the inspection we spoke with three dentists, one dental nurse, a 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 8.45am to 1pm and 2pm to 8pm, Tuesday to Friday 8.45am to 1pm and 2pm to 6pm.

Our key findings were:

• Effective leadership from the provider and practice manager was evident.
• Staff had been trained to deal with emergencies,appropriate medicines and life saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when they occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice were aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and emergency care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• The practice dealt with complaints positively and efficiently.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• Governance arrangements were embedded within the practice.

We identified an area of notable practice.

The practice demonstrated a proactive approach regarding ensuring staff understanding and application of the Mental Capacity Act 2005. The practice reviewed their patient list to identify any patients who may be affected by the Act as a result of their mental health changing. We were provided with specific examples as a result of the review which included: Particular patients were allocated longer appointment times to ensure the principles of the Act could be followed by dental staff. Information sheets and post operative instructions were created for the benefit of particular patients who experienced memory problems.

There was an area where the provider could make improvements. They should:

• Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

We saw that staff were very polite and welcoming to people entering the premises. We spoke to one person in private and she indicated, in very positive terms, that she was extremely pleased with the service she received. She only had the highest compliments for all the staff she came into contact with during her visits. She felt fully involved in her treatment and said that available treatment options were explained clearly, giving her the option to make choices.

The person we spoke with said that the practice was always clean. She confirmed that the dentists and nurses always offer them glasses to protect their eyes, wear these themselves and that they always wear disposable gloves. This lady told us she was treated by staff who always wear appropriate protective equipment. She told us she see’s the staff washing their hands before, during and after treatments. She concluded by saying that she thought the treatment rooms were very clean and hygienic.

We were shown copies of 'patient satisfaction' surveys that the practice carry out twice per year.

We saw a summary report of this survey. The most recent survey had 91 replies with the overwhelming response (98%) being very positive about the services offered and received.