We carried out this announced inspection on 5 September 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 that we were inspecting the practice. They did not provide 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

Synergy Dental Practices Limited - Summerfield Primary Care Centre is in Winson Green and provides NHS and private treatment to patients of all ages.

The practice is situated in a modern, purpose built NHS health centre which provides many other health services in addition to dentistry. There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including four for patients with disabled badges, are available near the practice.

The dental team includes four dentists, three dental nurses (two of whom are trainees), and one practice manager. The dental nurses also carry out reception duties. On the day of our visit, two of the dental nurses were on leave and the practice had asked an ex-employee to provide locum cover as the receptionist. The practice has two 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. At the time of the inspection the practice did not have a registered manager in post. We discussed this with the practice manager about this and they explained that the necessary paperwork was submitted in 2016. They assured us they would investigate this further.

On the day of inspection we collected 20 CQC comment cards filled in by patients and spoke with one other patient. This information gave us a positive view of the practice.

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

The practice is open between 9am and 5pm from Monday to Friday. It is also open on some Saturdays between 9am and 1pm.

Our key findings were:

• The practice was clean and well maintained. Staff made prompt arrangements to repair a defect in the flooring once this was brought to their attention.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available with the exception of a paediatric self-inflating bag. Five face masks are recommended but the practice held only two.
• The practice had systems to help them manage risk. Staff needed to review the practice’s current fire and Legionella risk assessments to ensure they had mitigated risks by following required actions.
• 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. Some aspects of record keeping required more details.
• 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 medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Review the practice's environmental risk assessments and ensure the fire and Legionella risk assessments are undertaken regularly and the necessary actions implemented.
• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review defects in the flooring and ensure that any necessary repairs are identified and repaired in a timely manner.
• Review availability of an interpreter services for patients who do not speak English as a first language.

We carried out this inspection to check on the treatment of people. Following the inspection we conducted telephone interviews with four people. On the day of the inspection we spoke with two dental nurses and a dentist who was one of the owners. The practice manager was also present to support the process.

The practice consisted of a reception/waiting area, two treatment rooms and a decontamination area. The toilet facilities on the ground floor were part of the NHS services in the building, which met the disability discrimination act (DDA) requirements. The entrance to the building allows people with reduced mobility easy access to the service.

Records showed that consent was recorded on people's treatment records. One person said, "Yes my consent is given and any possible costs explained".

We found a process in place to ensure people's treatment needs were clearly identified. One person said, "The services are really good".

The environment was clean and tidy. The provider had process in place to ensure any potential cross infection was reduced.

The provider had systems in place to ensure staff were appropriately checked to ensure their suitability to work with vulnerable people.

We found that the provider had a complaints process to ensure people were able to share their views.