We carried out this announced inspection on 17 May 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

Richmond Dental Practice is situated in a purpose built building in Malvern, Worcestershire. It provides NHS treatment to patients of all ages. The practice’s clinical team comprises of the principal dentist, four dentists, two dental hygienists, four qualified dental nurses and three trainee dental nurses. The clinical team are supported by two receptionists and a practice manager who is also a qualified dental nurse.

The principal dentist is registered with the Care Quality Commission (CQC) as the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 practice has a reception area, a waiting room, five dental treatment rooms and a decontamination room for the cleaning, sterilising and packing of dental instruments. The building is single storey and has level access for patients who use wheelchairs and pushchairs.

On the day of inspection we collected five 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 the principal dentist, two dentists, a 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 to Friday 8.30am – 5pm

Our key findings were:

• The practice was visibly clean and an employed cleaner was responsible for the day to day cleaning.
• The practice had well organised systems to assess and manage infection prevention and control.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice had a safeguarding lead with effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• Dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• Staff we spoke with felt well supported by the principal dentist and practice manager and were committed to providing a quality service to their patients.
• The practice dealt with patients’ complaints positively and efficiently.

There were areas where the provider could make improvements and should:

• Review the managment of prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review the practice’s protocols for recording the reason for taking the X-ray and quality of the X-ray ensuring compliance with the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
• Develop a recruitment policy in line with current procedures to ensure accurate, complete and detailed records are maintained for all staff including requesting two references.
• Develop a incident reporting policy in line with current procedures.

During this inspection we spoke with two dentists one of whom was the provider, two dental nurses, a receptionist and the practice manager. We also spoke with four people who used the practice.

People who used the practice were very complimentary about the care and treatment they received. One person said: “It’s an excellent dentist.” People told us they were given information about their treatment. One person said: “They always keep me well informed.” There was appropriate medication available for medical emergencies. We found staff were trained to know what to do if a person became unwell at the practice.

The practice was clean and people we spoke with confirmed that this was their experience. There were suitable arrangements in place for the cleaning, sterilising and storing of instruments so that people were not placed at risk of infection.

The dental team were qualified and maintained their continuous professional development (CPD) as required by the General Dental Council (GDC) so that they knew how to support people.

The provider had systems of audits in place to enable them to monitor the quality of the service provided. This made sure that people received appropriate care and treatment. People were asked for their views about the practice and these were listened to.