In response to concerns raised to the CQC we carried out this unannounced inspection on 10 July 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

South Road Dental Practice is in Stourbridge and provides NHS and private treatment to patients of all ages.

A portable ramp was available to gain access to the front of the building for people who use wheelchairs and pushchairs. Car parking spaces, including one for patients with disabled badges, are available at the practice. The practice also had an arrangement with the public house next to the practice to enable patients to park in their car park.

The dental team includes five dentists, seven dental nurses, three dental hygienists, one receptionist and a practice manager. The practice has four treatment rooms, three of which are on the ground floor and one on the first floor. There is a reception and waiting room on the ground floor and a separate waiting room on the first 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 South Road Dental Practice was the practice manager who was present during this inspection visit

On the day of inspection we did not collect any CQC comment cards filled in by patients as this inspection was unannounced. We spoke with two patients during the inspection. This information gave us a positive view of the practice.

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

The practice is open: 8.30am to 5pm Monday and Thursday, 8.30am to 6pm Tuesday and Wednesday and 8am to 1.30pm on Friday.

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. One piece of equipment was missing from the practice’s emergency medical equipment. We were told that this would be purchased immediately. Appropriate medicines were available which were checked on a regular basis.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff 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 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.
• The practice dealt with complaints positively and efficiently.

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

• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

This practice is located on the ground and first floor and a portable ramp was available to assist people who have restricted mobility. Treatment rooms and a disabled toilet were located on the ground floor. The premises consisted of a reception/waiting area, four treatment rooms, toilets and a decontamination room.

The dental team consisted of four dentists, three hygienists, a practice manager, seven dental nurses and a receptionist. During the inspection we spoke with five people who used the service, two dentists, the practice manager and three dental nurses.

We found that people were informed of their treatment options and their consent for treatment was obtained. One person who used the service said, "I was given a print out of my treatment plan and the cost and I signed this to give consent for treatment.”

Dental records provided detailed information about the treatment people had received and when a follow up appointment was required.

We found that the decontamination process for dental instruments was satisfactory to reduce the risk of cross infection. The cleanliness and hygiene standards of the practice were also satisfactory. One person who used the service said, “The practice is immaculate.”

The staff recruitment practices were satisfactory but improvements could be made to ensure systems were more robust.

Complaints were managed effectively to address concerns and to improve the service.