We carried out this announced inspection on 17 December 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

Victoria Road Dental Care is in Horley and provides NHS and private treatment to adults and children.

It was noted that the three dentists working at this location (practice) who are registered individually are a cost sharing partnership. This was discussed at the time of the inspection and all three have been advised and information given.

There is a lift to the 1st floor dental practice. It has level access for people who use wheelchairs and those with pushchairs. Car parking spaces across the road, including 3 blue badge holders, are available in the car park near the practice.

The dental team includes 3 dentists, 3 dental nurses,1 trainee dental nurse, 1 receptionist and a practice manager. The practice has 3 treatment rooms.

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.

On the day of inspection, we collected 45 CQC comment cards filled in by patients.

During the inspection we spoke with 3 dentists, 2 dental nurses, 1 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: 08.00 to 17.30 Monday to Thursday and Friday 08.00 to 13.30.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.
• Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.

Our inspection visit was undertaken across four hours during working hours at the practice. We told the provider in advance that we were visiting in order to ensure that we were able to speak to all the people we needed to. We spoke with four people who use the service either on the day of our site visit or via telephone following our visit. We also consulted with two staff members along with the provider.

People who use the practice told us they understood the care and treatment choices available to them. They told us that they were told about how much their treatment would cost. People consistently told us that they were happy with the service provided. A sample of peoples comments about their experiences included “a very pleasant practice always friendly” “they do pretty well looking after me, as I was reluctant to come but they have eased my anxieties over the years” and “It’s a very good friendly helpful practices they always explain what is going to happen”.

People told us they felt their dignity was maintained and their privacy protected. They were encouraged to ask questions and felt staff had the time to answer their queries.

People told us that the practice was comfortable and accommodating and that appointments were largely flexible to meet their needs. A person told us “they can usually fit you in quite quickly they always try and accommodate you”.

People consistently told us that they were satisfied with the standards of cleanliness. There comments included “it is old building but it is generally very clean. The nurses always seem very clean and always seem to be wiping things down” and “always very clean there is always a new cup of mouth wash”.

A person told us that they felt confident to raise any concerns or feedback they had with the dentist directly another person told us “If I was not happy I would just have a chat with him he is very approachable”.