We carried out this announced inspection on 7 August 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

The Cathedral Street Dental Practice is a well-established practice based in Norwich that provides both private and NHS treatment to about 2,000 patients. The dental team includes one dentist, two nurses, a hygienist and two receptionists. Another, separately registered, dental practice is based at the same location and shares some of the same staff, costs and facilities with this practice.

The practice opens on Mondays to Wednesdays from 8 am to 3 pm, and on Thursdays from either 11 am to 6pm. The practice is not open on a Friday but offers emergency cover.

The practice is owned by an individual who is the dentist. He has 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 22 CQC comment cards completed by patients, and spoke with another two. We spoke with the dentist, his nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• Information from completed Care Quality Commission comment cards gave us a positive picture of a caring, professional and high-quality service.

• The practice had effective systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• Risk assessment was robust and action was taken to protect staff and patients, although the practice’s fire risk assessment needed to be reviewed.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Patients received their care and treatment from well supported staff, who enjoyed their work.

• Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.

• The practice had effective leadership and a culture of continuous audit and improvement.

• The practice asked staff and patients for feedback about the services they provided. Staff felt involved and worked well as a team.

There were areas where the provider could make improvements and should:

• Review the fire safety risk assessment to ensure all risks are identified and oxygen cylinders are signposted.

During our inspection we saw people visiting the surgery were dealt with professionally and in a friendly manner by the staff.

We spoke with people who were attending the practice before they went in to see the dentist. They told us they were always given a copy of their treatment plan that showed the cost of the proposed treatment. They told us they felt respected by the friendly staff and were fully involved in the decisions taken about their dental care and treatment. Comments we received were: "The staff have been here for many years and I have always found them to be very professional." "I ask the dentist for his advice before making up my mind about the treatment I may need, he is very good at explaining beforehand."

The practice manager who accompanied us during our visit made available all the records we asked to see. They had systems in place to monitor and reduce cross infection, safeguard vulnerable people and keep people's records secure. There was the opportunity for people to air their views through the patient satisfaction survey and/or leave their comments in the suggestion box. We saw that the information gathered was used to improve the quality of care.