We carried out this announced inspection on 18 August 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide us with any information to take into account.

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 Mary’s Dental Practice is in Stamford, a town in the South Kesteven district of Lincolnshire. It provides mainly private treatment to patients of all ages. The practice has a small contract to deliver NHS services.

The practice building does not permit level access for people who use wheelchairs and pushchairs. Car parking is not available on site, but public parking is available within short walking distance of the practice. This includes spaces for disabled patients who are blue badge holders.

The dental team includes two dentists, three dental nurses, three receptionists and a cleaner. The practice also employs a practice manager. There are two treatment rooms; one is located on the first floor and one on the second 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 St Mary’s Dental Practice is Paul Williams.

On the day of inspection we collected 25 CQC comment cards filled in by patients. This information gave us a positive view of the practice. We did not receive any negative feedback about the practice.

During the inspection we spoke with two dentists, one dental nurse, a 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 and Tuesday 9am to 5.30pm, Wednesday 8am to 3.30pm, Thursday 9am to 6.30pm, Friday 9am to 5pm and alternate Saturdays from 9am to 12.30pm.

Our key findings were:

• The practice ethos included the provision of dental care of consistently good quality for its patients and ensuring their needs and wishes were met.
• Effective leadership from the provider and practice manager was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and lifesaving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting of untoward incidents and shared learning when any incidents or complaints occurred.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice were aware of the needs of the local population and took these into account when it was reasonably practicable to do so.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided.

The surgery had a comfortable reception area which displayed notices about the choice of appointments, opening times and fees.

All people were required to give their consent before any treatment was given. One person said, “I am always asked whether I want to go ahead with the treatment, all the options and costs get explained to me.”

Since access to St. Mary’s Dental was via a narrow staircase to the first floor, the practice had arrangements with two nearby dental surgeries to treat any patients with mobility difficulties who felt unable to climb the stairs. We were told the practice had investigated the installation of a stair lift to help people with the stairs but the design of the building prevented this.

Members of staff were trained in infection control and a range of policies and procedures were in place to support them in their work. This ensured they were aware of their responsibilities and knew the procedures to follow to prevent infections.