We carried out this announced inspection on 23 August 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 two specialist dental advisers.

We told the NHS England area team that we were inspecting the practice. They did not provide any information for us to take into account.

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

Total Dental Care – Saffron Lane is located in Leicester and provides mostly NHS treatment to patients of all ages. There are a small number of private patients registered.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available in the practice’s car park at the rear of the building. There are also a small number of spaces at the front of the building for disabled patients who are blue badge holders.

The dental team includes four dentists, (including the principal dentist) three dental nurses, (one nurse is a decontamination lead and one is a treatment co-ordinator) and two trainee dental surgery assistants. The practice is supported by an administrative manager and a practice manager who work across three other Total Dental Care sites in the City of Leicester.

The practice has three treatment rooms; two of these are located on the ground floor.

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 Total Dental Care – Saffron Lane is the principal dentist.

On the day of inspection we collected 40 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 dental nurse, a trainee dental surgery assistant and the administrative manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday 8.45am to 5.30pm and Friday 8.45am to 4.45pm.

Our key findings were:

• The practice ethos included the delivery of a high standard of dental treatment in a caring and safe environment.
• Effective leadership from the provider and practice management was evident.
• Staff had been trained to deal with emergencies and appropriate medicines and most lifesaving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected current published guidance.
• The practice had effective processes in place and staff knew their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• The practice had adopted a process for the reporting and shared learning when untoward incidents occurred in the practice. We noted that the process required some strengthening.
• Clinical staff provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The practice were aware of the needs of the local population and took these into account when delivering the service.
• Patients had access to routine treatment and urgent care when required.
• Staff received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice.
• Staff we spoke with felt supported by the provider and were committed to providing a quality service to their patients.
• The practice asked staff and patients for feedback about the services they provided.

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

• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.
• Ensure practice policy and the principle of Gillick competence is incorporated.

We spoke to three people who had just received treatment. They only had the highest compliments for all the staff they came into contact with during visits. They all felt fully involved in treatment and understood the care and treatment choices available to them. These people were given appropriate information, including a treatment plan, regarding their care and treatment.

People told us that staff were polite, courteous and welcoming when they entered the premises. One lady we spoke to had received a lot of treatment over the past few months and felt that the dentist had done a good job. She said that even though it was a long period of treatment she felt the treatment was planned and delivered in a way that made her feel safe.

People told us they thought the surgery was clean and tidy. One person said, “I have no issues with the cleanliness here. The dentist always wears gloves and a mask and they give me goggles to protect my eyes.” Another person commented, “Everywhere always looks immaculately clean.”

One person said, “The dentist is excellent at putting patients at ease and is also excellent with children.”

People told us they thought the practice offered a good quality service. One person said, “I’ve never had cause to complain, but if I had any issues about anything I would tell the staff and they would sort it out.