We carried out this announced inspection on 25 July 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

Torrs Park Dental Practice is in Ilfracombe and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available at the practice.

The dental team includes three dentists, one qualified dental nurse, two trainee dental nurses, two receptionists and a practice manager (who is also a qualified dental nurse). The practice has two treatment rooms.

The practice is owned by a partnership 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 Torrs Park Dental Practice was the practice manager (who is also one of the partners).

On the day of inspection we collected 49 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, one qualified dental nurse, one trainee dental nurse, one 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 to Thursday 9am - 1pm and 2pm - 5.30pm. Friday 9am - 1pm and 2pm - 4.30pm.

Our key findings were:

• The practice was 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 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.

We identified two areas of notable practice.

• The practice was spearheading a community outreach project which organised donations of items, including oral health products, for vulnerable people in the local community, throughout the year.They also organised an annual local Christmas shoebox gift appeal for vulnerable people in the community. The practice donated oral hygiene kits and assisted in the distribution of the boxes.We were told that these schemes supported approximately 280 people in the last 12 months, who were not accessing a dental service. This showed compassion for vulnerable groups who may not be able to afford oral health products.

• The practice had identified key areas of need within the local community and was providing outreach oral education services to community groups. These projects had been running for two years. The aim was to tackle an identified problem of tooth decay in children and vulnerable adults locally. The dentists and dental nurses approached local schools and nurseries and attended community events to give oral hygiene advice and give out toothpastes.They actively engaged children by running competitions for them to design leaflets with the information they learnt in the educational sessions. The practice used the local newspaper to promote good oral health advice and had on-going links with four schools, two nurseries and two town community health projects. The practice showed us how they supported a local halfway house, foodbank and young families' centre with oral hygiene products and information. These initiatives showed a deep commitment to the promotion of oral health in the community.

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

• Review the practice's recruitment policy and procedures to ensure complete and detailed records are maintained for all staff.
• Review the practice protocols and procedures for the use of rectangular collimation, giving regard to the 2001 Department of Health ‘Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment’.

We carried out a routine inspection of Torrs Park Dental Practice on 26 April 2013. We looked at four people’s records in detail and spoke with them after the consultation. We met another three people who attended appointments and spoke with them about their experiences of treatment at the practice.

People made positive comments about their experiences. These included: “I don’t have any complaints” and “We’ve been coming here for years and if we didn’t like it here we’d walk”.

People told us that the dental practice had discussed treatments with them, and provided an estimate of costs about the treatment available to them. For example, one person told us ““It’s very good they checked everything were very thorough in explaining. Nothing was wrong so I am pleased”.

People were safe and we saw that the practice followed strict procedures to protect vulnerable people. For example, staff followed up people to ensure they attended appointments at the local hospital when their care needed to be referred to a specialist. People told us the staff were “Very professional and very kind”.

People told us that the environment was “Always very clean”.

We made one compliance action at this inspection to ensure the assessment and monitoring of potential risks was effective. We also highlighted the provider may find it useful to note that the access to decontamination areas could be made more secure to prevent potential risks to people using the service.