We carried out this announced inspection on 15 May 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Bath Dental Clinic is in the centre of Bath and is a specialist referral centre providing wholly private treatment to adults and children. The practice provides prosthodontics including dental implants, periodontics, endodontics, paediatric dentistry and treatment under sedation.

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

The dental team includes five dentists, three dental nurses, one dental therapist and one 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. The registered manager at Bath Dental Clinic was the principal dentist.

On the day of inspection we collected 38 CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with four dentists, three dental nurses, one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday – Friday 09.00am – 5.00pm.
• Saturday by appointment
• Out of hours information is displayed on the website and via the telephone answering service.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures. However recruitment systems for agency staff required review.
• 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff including agency and locum staff.
• Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective, including appropriate fire training for staff.
• Review the practice induction process to ensure fire safety and awareness is included.
• Review the system for monitoring training to ensure staff completion of training within appropriate timescales.