We carried out this announced inspection on 23 January 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

Ripley Dental Practice is owned by two principal dentists who are equal partners in the business. The practice is an NHS and private dental practice located at the end of a row of retail shops and businesses.

The ground floor has a waiting room, reception desk, two treatment rooms and a small office. On the upper level there are two further treatment rooms, a decontamination room, an X-ray room, toilet and a large waiting room that is currently not in use for patients.

The staff team consists of eight dentists (including 2 orthodontists), four dental nurses (including two trainees), a dental hygienist, a receptionist and a practice manager.

One of the principal dentists is registered with the Care Quality Commission (CQC) as an individual. 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 is open Monday to Friday from 8:30am to 5:30pm.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Before the inspection we sent Care Quality Commission (CQC) comments cards to the practice for patients to complete to tell us about their experience of the practice. We collected eight completed cards. All the comments from patients were positive about the care they received from the practice.

Our key findings were:

• 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.
• 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 completed 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.

We noted that information about safeguarding people from abuse was available in the waiting rooms and public areas. In addition we confirmed that all staff in the service had received safeguarding training since 3 December 2012. This meant that people and staff had increased awareness of abuse and information on how to report concerns. Staff told us, “All staff and dentists have been trained now and we’re more aware of it”.

We found that complaint forms had been introduced and provided for use by people who used the service. Staff had been made available to help people to complete them if assistance was required. We also saw that a system of recording and tracking complaints had been introduced. The system enabled the service to demonstrate the action that had been taken to resolve complaints and show that the complainant had been made aware of the outcome. A member of staff told us, “It’s much clearer to everyone now exactly what has happened”.

This meant that the complaints system was more accessible to people who used the service and that complaints and comments were likely to be dealt with appropriately.

We were able to speak with people who used this service during and after our inspection. They were happy with the standard of service and treatment they had received. One told us, “I’ve been coming here for over five years and I live about five miles away. I feel safe and confident here”. Another person said, "The staff are very friendly and helpful".

People were pleased with the level of information provided by the service and the opportunity to make informed decisions about their treatment. One person told us, “Once the dentist took x-rays. He showed me the problem and we talked about what to do next”.

This service had a set of policies covering all aspects of the essential standards of quality and safety. Although people told us that they always felt safe in the service, we found a lack of staff awareness and information for service users relating to safeguarding people from abuse.

The standards of hygiene and infection control were found to be compliant. Effective procedures based on current guidance were in place.

The service displayed a notice for people explaining the complaints procedure. This was not supported by a process which responded appropriately to people's concerns