We carried out an announced comprehensive inspection on 4 August 2016 to ask the practice the following key questions: Are services safe, effective, caring, responsive and well-led?

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

Space Healthcare is situated in Leamington Spa, Warwickshire and provides private dental treatment. The practice has one dentist, one dental nurse and two dental hygienists both of whom work part time. The clinical team are supported by a business manager and a clinical care manager. Space Healthcare also provides laser eye surgery and cataract surgery at the same site but at this inspection we inspected the dental care service only. We will inspect the eye surgery service on another occasion.

The director of Space Healthcare Limited is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 practice has three dental treatment rooms and a separate decontamination room for the cleaning, sterilising and packing of dental instruments. There is level access from the front entrance and throughout the building which has wide corridors and doorways and a large reception and waiting area. The patient toilet is has a grab rail for patients with physical disabilities and is large enough for anyone who uses a wheelchair.

The practice is closed on Mondays. It is open from11am to 7.30pm on Tuesdays, from 9am to 5.30 on Thursdays and 9am to 5pm on Fridays. The practice is also open on Saturdays from 9.30pm to 4pm.

Before the inspection we sent Care Quality Commission comment cards to the practice so patients could tell us about their experience of the practice. We collected 30 completed cards and looked at 12 patient comments on an independent review website and another 12 on a social media site. All the information we gathered about patients views of the practice were positive. Many had taken time to write detailed comments about their experiences at the practice. They described their appreciation of the standard of care and treatment they received from the dentist and the other members of the practice team. They described them as approachable, attentive, professional and reassuring. Several patients mentioned how the dentists provided careful and detailed explanations about their treatment and most commented on the standard cleanliness at the practice.

Our key findings were:

• The practice was visibly clean and feedback from patients confirmed this was their experience.
• The practice had suitable child safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• The practice had clear processes for dealing with medical emergencies and for maintaining the equipment used at the practice.

• Dental care records provided clear and detailed information about patients’ care and treatment.
• Staff received training appropriate to their roles.

• Patients were able to make routine and emergency appointments when needed.

• The practice used an independent review website and social media to enable patients to give their views about the practice. They planned to introduce additional in-house patient surveys to develop this further.

• Patients were positive about the service provided by the practice. They said this met their needs and that they had full confidence in the practice team.

• The practice had established governance processes to help them manage the service but these needed strengthening in some areas.

There were areas where the provider could make improvements and should:

• Review the practice’s safeguarding policy, procedures and staff training to include information about safeguarding adults as well as children.
• Review the practice’s infection control procedures and protocols and staff awareness of these giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the current legionella risk assessment giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice on the prevention and control of infections and related guidance’. This should provide assurance that the person completing the assessment has the appropriate experience and competence.
• Review the training, learning and development needs of individual staff members and establish an effective process for staff induction, assessment, supervision and appraisal.
• Review the practice's recruitment arrangements so an effective process which reflects relevant legislation and guidance is in place for future staff appointments.
• Review the practice’s audit and quality monitoring arrangements, including those for dental care records and infection prevention and control. Audits should include documented learning points and evidence of improvements made.
• Review the provision of a hearing loop to assist patients who use hearing aids.