We carried out this announced inspection on 14 November 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

South Ham Dental Practice known locally as Damira South Ham is in Basingstoke and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes ten dentists, one lead dental nurse, two dental nurses, eight trainee dental nurses, three dental hygienists, one deputy practice manager, one practice manager and six receptionists. The practice has ten 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 South Ham Dental Practice known locally as Damira South Ham is the practice manager.

On the day of inspection we collected 28 CQC comment cards filled in by patients and spoke with 11 other patients.

During the inspection we spoke with four dentists, three dental nurses, four trainee dental nurses, one head receptionist, five receptionists, one deputy practice manager, one area manager and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Sunday 8am to 8pm

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 life-saving equipment were mostly available.
• The practice had systems to help them manage risk to patients and staff.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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.
• The provider 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 provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ in particular to consider the replacement or repair of worn out bench tops, the control of temperature and ventilation, levels of automated cleaning to match practice workloads, and the introduction of a reverse osmosis machine to produce de ionised water.
• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

We spoke with five people who used the service, the area manager, the manager and three other staff members.

We found that dentists and dental nurses made sure that people understood the treatment options available to them and had given their informed consent before any consultation took place.

People were treated in line with their agreed plan. People we spoke with told us that they were given enough information about their options and choices. One person said “they are brilliant, very good at explaining things”. Another said “they are spot on, I have no complaints”. Another person we spoke with said “it’s very good, the staff are excellent”. Medical histories were checked regularly by reception and by the dentist at every appointment.

The practice was clean and tidy. There were processes in place to ensure that risk of cross infection was minimised.

Staff felt well supported and the provider took steps to ensure that staff were qualified and experienced.

There was and effective assessing and monitoring process in place.