We carried out this announced inspection on 17 October 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.

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 Ilchester Dental Practice is in Ilchester, near Yeovil, Somerset and provides private treatment to patients of all ages.

There is no accessibility for people who use wheelchairs and pushchairs due to stairs upon entry to the practice. The practice does not have a car park. There are local transport services available and free car parks nearby.

The dental team includes a dentist, two dental nurses, two trainee dental nurses, a dental hygienist, a treatment coordinator and two receptionists. 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 The Ilchester Dental Practice was the practice manager.

On the day of inspection we collected six CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, two trainee dental nurses, one dental hygienist, a treatment coordinator, the 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, Wednesday, Thursday and Friday from 8:15am to 5pm
• Tuesdays from 8:15am to 6pm
• Wednesdays there is only reception and emergency dental care cover within the practice
• Out of hours cover is provided by the dentist upon request

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance. Although some improvements should be made.
• Staff knew how to deal with emergencies. Although training for one clinical member of staff was overdue by seven months. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place. These procedures required improvement to ensure current legislation was met.
• 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.
• 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 the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff including self-employed staff. This includes regular annual appraisals for all staff and ensuring staff kept up to date with training, particularly in infection control, medical emergencies and child safeguarding.
• Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
• Review the fire safety risk assessment to ensure all identified areas are addressed to improve fire safety within the practice.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.