We carried out this announced inspection on 18 December 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Resolution Specialist Treatment centre is in Yeovil and provides NHS and private orthodontic treatment to adults and children. The practice also offers implants and specialist endodontic (root canal treatment) and periodontic (gum disease) treatments to private patients.

There is level access, via a removable ramp, for people who use wheelchairs and those with pushchairs. Car parking spaces, including for blue badge holders, are available near the practice.

The dental team includes two orthodontic specialists, six dentists of whom one has a special interest in endodontics (root canal treatment); one who has a special interest in periodontics (gum disease); two who have a special interest in orthodontics and two who have a special interest in placing implants. The practice has 11 dental nurses, three orthodontic therapists; three treatment coordinators, five receptionists and five administrators. The practice has six 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 38 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with five dentists, five dental nurses, one orthodontic therapist, two receptionists, three administrators 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 & Tuesday - 08.30am – 5.00pm
• Wednesday & Thursday - 08.30am – 7.00pm
• Friday - 09.00am – 5.00pm
• The practice reserves the following times for private patients:
• Wednesday – 4.00pm – 7.00pm
• Thursday - 5.00pm – 6.30pm
• Saturday - 09.00am – 5.00pm
• Sunday - closed.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the fire safety risk assessment and ensure that any actions required are completed and ongoing fire safety management is effective. In particular relating to staff fire awareness training and the fire alarm testing points.

We spoke with young people and their parents attending for appointments. They told us they were referred to the practice by their own dentist. They said they were given information leaflets and had explanations about what to expect. One young person described the staff as “very friendly and informative” and the practice as “clean and tidy”.

Information was made available to people and they were involved in making decisions about their treatment. Good records were maintained about the treatment provided and there were arrangements in place to deal with medical emergencies. Staff received training opportunities and were aware of arrangements should they have cause for concern about a child or vulnerable adult.

The premises were suitable and accessible and there were arrangements in place to control the risk of infection.

The staff in the practice felt supported and there were sufficient staff for the running of the service. The provider had systems in place so that staff were appropriately checked before they were appointed.

The provider had a range of systems in place to monitor the quality of the service provided including asking people who used the service for their views. The service responded appropriately to any complaints received.

We looked at the NHS Choices website where there was the facility for people to comment on services providing NHS subsidised treatments. There were no comments on the Choices website for this service.