We carried out this announced inspection on 14 February 2019 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 practice is located in Rothley, a village within the Borough of Charnwood in Leicestershire. It provides NHS and private treatment to adults and children.

The premises do not have level access and are therefore not suitable for people who use wheelchairs and those with pushchairs. Staff advised those who contact the practice that there is another practice, also run by the provider that has accessibility.

Public car parking is available within close proximity to the practice.

The dental team includes a compliance manager, two dentists, three dental nurses, one dental hygienist and two receptionists. The practice has two treatment rooms.

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 Rothley Dental Practice is the compliance manager.

On the day of inspection, we collected 48 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, three dental nurses and the compliance manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Wednesday from 9am to 5pm and Thursday and Friday from 9am to 4.30pm.

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 most life-saving equipment were available, with some exceptions. An order was placed for new items required on the day of our visit.
• The practice had systems to help them manage most risks to patients and staff. We noted that fixed wiring testing was overdue for completion and a risk assessment was required for one of the clinical staff who was not responsive to the Hepatitis B vaccine. A risk assessment was completed after our visit.
• The provider had suitable safeguarding processes, although the policy required update and one of the dental nurses had completed their training to level one. Policy was updated after the inspection and the staff member updated their training to level two. Staff showed awareness of their responsibilities for safeguarding.
• 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 had systems to deal with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities in relation to this.
• Review the practice’s protocols and procedures for the use of rectangular collimators fitted to X-ray machines to reduce radiation dose to patients.

When we visited the offices of the dental practice we spoke with people using the service. One person told us they thought this practice offered a good quality service, and also said, “I have been coming here all my life, all of our family have. There have never been any problems, the staff are all very nice and helpful.” Another person said “People do their job in an exemplary way.”

We saw that staff were polite and welcoming to people entering the premises. We spoke to a number of people who use the practice and they indicated they were very pleased with the service they received. They felt their privacy, dignity and independence were respected. They also felt they were consulted and involved in their treatment and felt safe as they were seen in premises that maintained a good level of cleanliness.

People also felt that they were consulted about their treatment, offered options and asked about the quality of service provided and how this could be improved.