We carried out this announced inspection on 9 January 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

Treeline Dental Care is situated in the village of Keyworth to the south east of Nottingham. The practice provides a mixture of private and NHS dental treatments (approximately 70% NHS) to patients of all ages.

The practice has four treatment rooms, one of which is located on the ground floor. There is free car parking available close to the practice.

The dental team includes: seven dentists; one foundation dentist; one visiting Implantologist; one visiting Endodontist; one specialist oral surgeon; one dental hygienist; one dental therapist; five qualified dental nurses (including the practice manager, the practice support manager, and the clinical support manager); three trainee dental nurses; and one receptionist.

The practice is a training practice with one foundation dentist working at the time of this inspection. A foundation dentist is a newly qualified dentist gaining experience in a supported environment for the first year after qualification.

The practice is owned by an organisation 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 practice is the principal dentist.

On the day of inspection we received feedback from 49 patients. This information gave us a positive view of the practice.

During the inspection we spoke with four dentists, one dental hygienist, four dental nurses (including two trainee dental nurses) and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice opening hours are: Monday: 9 am to 6 pm; Tuesday: 9 am to 6 pm;

Wednesday: 9 am to 8 pm; Thursday: 9 am to 8 pm and Friday: 9 am to 5 pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and 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 measures to protect their privacy and personal information.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice dealt with complaints positively and efficiently.

We spoke with two patients, observed two more patients during our visit and spoke with three members of staff.

Patients told us they were treated with dignity and respect when attending the practice.

The practice was on the first floor with a chair lift available for people who were unable to use the stairs. The stairs opened directly into the main reception area and staff said if patients required assistance with the stairs they could notify the receptionist.

Patients told us they received good information regarding their treatment which helped them make informed choices to meet their needs.

Patients and staff told us information about care and treatment was available for their use. this included leaflets such as oral hygine, practice information, prices and other information regarding mouth cancer and patient advice and liaison services. (PALs).The practice manager told us they encouraged patients to read the leaflets and take them away with them to ensure they understood the treatments that were offered.

The patients we spoke with commented on the cleanliness of the environment and protective equipment was always used.

We saw patient questionnaires had been completed in April 2012. These contained generally positive comments with strength and weaknesses of the surgery identified. We saw action had been taken to address the areas of weakness where required.