We carried out this announced inspection on 6 April 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. In addition, there was a newly recruited specialist dental adviser who attended the inspection.

We told the NHS England area team that we were inspecting the practice. They did not provide any information.

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

Solvay Solutions UK (Dental Department) is a dental practice within an industrial manufacturing unit and provides NHS treatment to employees and retired employees of the company.

There is level access for people who use wheelchairs. Car parking spaces, including for patients with disabled badges, are available near the practice.

The dental team includes one dentist and one dental nurse. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 31 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the whole dental team which comprised of the principal dentist and dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open on Wednesdays and Thursdays between 8:30am and 12:30pm.

Our key findings were:

• The practice was clean and well maintained.
• 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. We identified some necessary improvements.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding their patients.
• There was no evidence that the practice had thorough staff recruitment procedures. The practice team had remained the same for over twenty years and no new staff had been recruited since.
• 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.
• No complaints had been received by the practice.

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

• Review availability of medicines, staff training and equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK) and the General Dental Council (GDC) standards for the dental team.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure that all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. The practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.

During this inspection we spoke with the provider and staff at the practice. We also conducted telephone interviews with six people who used the service.

We found that people had the information they needed to help them make informed choices about their treatment. One person told us, "Everything is explained well and any treatment that you need is discussed, so you know the options available".

People told us that they had no concerns about the care and treatment that they received. One person said, "I was having trouble with my teeth and the dentist did a brilliant job".

We found that people received care and treatment in a clean and hygienic environment. People that we spoke with had no concerns about the cleanliness of the environment. One person told us, "It's always very clean".

People that we spoke with were complimentary about the staff. We found that staff were trained and supported to deliver treatment to an appropriate standard.

We found that the provider had systems in place to monitor the quality of service that people received. People that we spoke with confirmed that the treatment they received was of good quality.