We carried out this announced inspection on 5 July 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 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

Salisbury Villa Ltd is in Teignmouth and provides NHS and private treatment to adults and children.

There is lift level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available nearby in the town. Disabled drivers can drop off outside the practice.

The dental team includes three dentists, one foundation dentist in their first year after qualifying, five dental nurses, one trainee dental nurse, one dental hygienist/therapist and one receptionist. The practice has four 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 Salisbury Villa Ltd was the principal dentist.

On the day of inspection we collected 50 CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with three dentists, four dental nurses, one dental hygienist/therapist, one trainee dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Mon – Thu 8:30am – 6pm. Fri 9am – 5pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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; some improvements could be made.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• 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 had not received any complaints in the last 12 months.
• The practice staff had suitable information governance arrangements.
• The practice had an informative and educative website.

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

• Review the sharps policy and sharps risk assessment to consider the practice of dismantling, in order to decontaminate, matrix bands.
• Review systems for stock control of processed dental instruments.

We spoke with ten patients. All these patients were happy overall with the treatment they had received. Where appropriate they had been given treatment options and the information they needed to be able to make their choice. They felt that their decisions and opinions were respected by the staff.

We found that patients were given appropriate information about their treatment. Information was collected and updated about patient's medical conditions to ensure patients remained safe when being treated. Equipment was available and staff trained to deal with medical emergencies.

Patients were cared for in a clean, hygienic environment.

There was a commitment on the part of the provider to staff training and development and by all staff themselves to remaining appropriately trained and to enhance their knowledge and skills. Patient records were compiled and maintained adequately and stored and, where appropriate, destroyed securely.