We carried out this announced inspection on 28 November 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

Sixteen A Dental Care is situated in the south Derbyshire town of Swadlincote. The practice provides mostly NHS dental treatment (99%) to patients of all ages.

The practice has four treatment rooms, all of which are located on the first floor. The treatment rooms are accessed by a flight of stairs. There is designated free car parking close to the practice.

The practice was a training practice with two foundation dentists working there at the time of this inspection. A foundation dentist is a newly qualified dentist gaining experience in a supported environment for the first year after qualification.

The dental team includes: six dentists; two foundation dentists; three qualified dental nurses; four trainee dental nurses and a practice manager.

The practice is owned by an organisation 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 the practice was the principal dentist.

On the day of inspection we collected 12 completed CQC comment cards and spoke with two patients in the practice. This information gave us a positive view of the practice.

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

The practice opening hours are: Monday: 8:30 am to 5 pm; Tuesday: 9 am to 5:30 pm;

Wednesday: 8:30 am to 5 pm; Thursday: 8:30 am to 5 pm and Friday: 8:30 am to 5 pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and knew their responsibilities for safeguarding adults and children.
• The practice 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 measures to protect their privacy and personal information.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice did not have an induction hearing loop to assist patients who used a hearing aid.
• The practice dealt with complaints positively and efficiently.

We spoke with people who use the service. They told us staff were friendly and approachable and spoke to them in a respectful way. People told us staff treated them with dignity and communicated well. One person told us “They are always really nice”. A second person said “They (staff) are lovely, very nice.”

People told us they had discussed the treatment options available to them and felt they were able to make informed choices about their treatment. One person said “She (the dentist) always gives you a choice.” This shows that people who use the service understood the care and treatment choices available to them. None of the people we spoke with had experienced any difficulty in making appointments. One person said “I’ve never have any problem getting appointments.”

People told us they felt the practice delivered care and treatment in a way that met their needs; they felt safe at the service and never seen anything of concern. They felt the practice was clean and staff always wore gloves and other protective clothing to prevent cross contamination; this was confirmed by our observation on the day. We saw that the practice had systems to reduce the risk of infection.

People told us they had the opportunity to give feedback about the service. The practice patient information leaflet contained information about opening times, emergency contacts, fees and the complaints procedure.