We carried out this announced inspection on 15 December 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

The practice is in Sleaford, a market town in the North Kesteven district of Lincolnshire. The practice provides private treatment only to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including some allocated for patients who are blue badge holders, are available in the practice’s car park. Car parking arrangements are shared with other local businesses.

The dental team includes two dentists, two dental nurses and a patient co-ordinator. Receptionist duties are shared amongst the patient co-ordinator and dental nurses.

The practice has two treatment rooms; both of which are on the ground floor.

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 Sleaford Smile Centre is the principal dentist.

On the day of inspection we collected 23 CQC comment cards filled in by patients. This information gave us a positive view of the practice. We did not receive any negative feedback about the practice.

During the inspection we spoke with the principal dentist, two dental nurses and the patient co-ordinator.

We looked at patient feedback obtained, practice policies and procedures as well as other records about how the service is managed.

The practice is open: Monday, Tuesday, Wednesday and Friday from 9am to 5pm and alternate Saturdays.

Our key findings were:

• Effective leadership from the provider was evident.
• Staff had been trained to deal with emergencies. Appropriate medicines and lifesaving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when they occurred in the practice.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice was aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continuing professional development (CPD) by the practice.
• The practice had systems to address complaints effectively.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• Governance arrangements were embedded within the practice.

We used a number of different methods to help us reach a judgement on this service. These including talking with two patients using the service, two members of the staff team and one dentist who was also the registered manager. We also looked at records. These included care plans, records of meetings and information about how the service operated. We looked at information from audits undertaken by the provider to assess the quality of service.

Patients we spoke with said they were fully involved in their care and treatment options; felt it was delivered in a safe way and that the practice was clean and hygienic. One patient we spoke with said, "Probably not the cheapest in town but probably the best. It’s five star.”

We observed members of staff interacting with patients in a courteous, polite and efficient manner.

Staff were encouraged to develop their skills and undertake appropriate training to help deliver safe and effective care to patients.

We saw that the practice had a clear infection control policy and that staff were fully aware of it and knew how it should be implemented. However, the registered manager was unable to produce any records that showed that an assessment had been completed to help protect patients, staff and others from the risk associated with the Legionella bacteria.