We carried out this announced inspection on 20 November 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

The Range Dental Practice is in Whitehaven and provides private dental treatment to both adults and children.

The practice is situated in the town centre and is housed in a listed Georgian building. There is no level access for people who use wheelchairs and pushchairs. Any potential new patients are informed of this when they first enquire about the practice and are given details of other local practices which do have ground floor access. Car parking spaces are available near the practice.

The dental team includes two dentists, five dental nurses, one dental hygienist and three receptionists. The team is supported by a practice manager and a deputy practice manager. The practice has two treatment rooms situated on the first floor of the practice.

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 48 CQC comment cards filled in by patients. This information gave us a very positive view of the practice.

During the inspection we spoke with two dentists, one dental nurse, two 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 and Wednesday 9.00am – 5.00pm

Tuesday and Thursday 9.00am – 6.00pm

Friday 9.00am – 1.00pm

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.
• Dental records were very detailed and informative.
• 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.
• 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 the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the practice’s systems in place for environmental cleaning taking into account current national guidelines.

This service made sure that people had the right information to make informed consent to treatment. They took steps to ensure that people felt at ease when they came to the surgery and that they had access to information.

The care and treatment given was of a good standard with patient satisfaction levels scoring highly when quality monitoring was completed by the surgery. We saw good evidence of appropriate care and treatment.

Staff in the service were trained to recognise any potential abuse of children or vulnerable adults. Suitable arrangements were in place to manage any issues around abuse.

There were good infection control measures in place. Surgical instruments were cleaned and stored correctly. Emergency care could be given because staff were fully trained and equipment was available for any adverse event.

The dentist and dental nurses were appropriately trained and supported to give good standards of care and treatment. Administrative and management staff were also suitably trained.

The service had detailed and thorough quality monitoring procedures and we met people who were happy with the treatment and services provided. One person told us:

"I had not been to the dentist for years...but gradually I got to trust the staff here and I have been able to have treatment... that I thought I couldn't face without being knocked out...Their professionalism and reassurance helps a great deal.The welcome I get almost makes coming to the dentist a pleasure!"