We carried out this announced inspection on 06 December 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 Healthwatch that we were inspecting the practice. They did not provide any information.

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 Old Clockmakers Dental Surgery is located in Cuckfield, near Haywards Heath. It provides private treatment to patients of all ages.

The practice occupies a Grade II listed premises on one level. There is one treatment room and a separate reception and patient waiting area.

The dental team includes the principal dentist and three qualified dental nurses; one of whom is the practice manager.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection we spoke with all the staff members. We looked at practice policies and procedures and other records about how the service is managed.

On the day of inspection we collected the views of 47 patients on the service. This information gave us a positive view of the practice.

The practice is open: Wednesdays and Fridays from 7.30am to 6pm and Saturdays from 7.30am to 1pm.

Our key findings were:

• The practice appeared clean and well maintained.
• 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.
• 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 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.
• The practice had effective leadership. Staff felt supported.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

At our last inspection in December 2013 we found that patients who used the practice or others acting on their behalf, who paid the provider for the services they received, would not always know how much they were expected to pay when and how. In the patient records we looked at we saw that the cost of the examination or treatment was recorded. However, it was not clear whether this had been communicated to the patient. There were no records of any written treatment plans.

This meant that the practice was unable to demonstrate transparency in its information about any of the fees, contracts and terms and conditions of any payments for care and treatment provided to patients. Patients therefore would not always know what the practice would provide for the fee paid or understand their obligations and responsibilities.

The provider was required to submit a plan detailing the action they would take to ensure compliance with this standard and the date at which they would be compliant. The provider told us in their plan that they would be compliant with these standards as soon as possible.

At this inspection we spoke with the practice manager and reviewed the actions they had taken to ensure that patients would always know what the practice would provide for the fee paid or understand their obligations and responsibilities. We found that the provider had taken sufficient action to address the areas of non-compliance.

We spoke with four patients who used the service. They all spoke positively about their experience. One patient described the practice as, "Excellent". Another said, "It's very, very good. I'm always satisfied."

All of the patients we spoke with said the dentist explained their care and treatment. However, they told us that they did not always know how much their care and treatment would cost and did not receive written treatment plans. This meant they did not always know in advance how much they were expected to pay.

The practice had policies and procedures in place to safeguard children and vulnerable adults. The staff we spoke with were aware of their roles and responsibilities in relation to this. This meant that patients who used the service were protected from the risk of abuse.

The practice had a system in place for controlling the risk of infection. All of the patients we spoke with said they thought the practice provided a clean and hygienic environment.