Eight people who used this service completed our questionnaires during the inspection visit. People were generally very positive about the service they received. One person said "I am overall satisfied. The staff are nice". Another person said "They are always helpful and polite".

We found that people had been given enough information to make a choice about their care and treatment and they had been treated with respect.

People who used the service had had their needs assessed and planned for and treatment had been delivered to meet their individual needs.

We found that effective procedures and practices were in use which protected people form the risk of infection and provided a clean environment.

The provider had not completed all of the pre-employment checks or provided all of the information that was a requirement when people were employed at this practice.

There were effective quality monitoring systems being used that had identified where improvements to the service could be made. Actions to improve the service had been taken after consultation with some of the people who used this practice.

We carried out this announced inspection on 20 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 not providing well-led care in accordance with the relevant regulations.

Background

Heath Dental Suite is in Fleet and provides NHS and private treatment to patients of all ages. Heath Dental Suite shares premises with Fleet Medical Centre.

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

The dental team includes four dentists, six dental nurses, three dental hygienists, one dental hygienist therapist three receptionist a practice manager. The practice has four 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 the Heath Dental Suite is the principal dentist.

On the day of our inspection we collected 98 CQC comment cards filled in by patients and spoke with 19 other patients.

During the inspection we spoke with two dentists, two dental nurses, two dental hygienists, two receptionists 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, Tuesday and Thursday, 7.30am to 5pm on Wednesday, 7.30am to 2pm on Friday and 9am to 12pm one Saturday a month.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance but were not followed.
• Staff knew how to deal with medical emergencies.
• Appropriate medicines and life-saving equipment were generally available but some equipment was missing.
• 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.
• Staff felt involved and supported and worked well as a team.
• The practice had systems to deal with complaints positively and efficiently.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The practice did not have effective governance.
• The appointment system met patients’ needs.
• Staff training was not monitored effectively.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care. Specifically, audits, risk assessments, health and safety management and radiography.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.
• Review the practice's protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.
• 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.