We carried out this announced inspection on 13 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

St. George’s Dental Practice is in Truro and provides mostly NHS and some private treatment to adults and children.

There is ramp access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. Blue badge holders can drop off outside the practice.

The dental team includes two dentists, two dental nurses, two trainee dental nurses, two reception staff and a practice manager. The practice has four treatment rooms.

The practice is owned by individuals who are the dentists there (Both dentists have individual CQC registrations at the practice). 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 19 CQC comment cards filled in by patients. This gave us a positive view of the practice.

During the inspection we spoke with two dentists, two 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: Monday to Friday 8am – 4:30pm (closed for lunch 1 – 2pm).

Our key findings were:

• Staff knew how to deal with emergencies.
• The practice staff 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 practice 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 practice had not received any complaints in the last 12 months.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, the current arrangements for storing clinical waste inside the premises, staff handling of x-ray developer fluid and the unsecured electrical consumer unit.
• 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, by addressing actions identified in the most recent practice infection control audit and development of a further action plan identifying how the practice will achieve best practice recommendations.
• Review the practice’s systems for formally recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.

We spoke with three patients who received treatment the day of our visit. They were long-standing patients of the practice. They told us that the staff were helpful and listened to them and that the surgery environment was clean and comfortable.

The patients told us that they were very happy with the treatment they had received and were given options and able to choose the course of treatment. They felt that their decisions and opinions were respected by the staff.

We found that people were given appropriate information and choices about their treatment options. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There was a thorough system of maintaining all equipment used in the practice with an effective system in place that reduced the risk and spread of infection. This was supported by all staff and we found a strong commitment to ensure they remained appropriately trained and maintain high standards of care.