We carried out this announced inspection on 20 February 2019 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

Weaverham Dental Surgery is in Weaverham, near Northwich, Cheshire and provides NHS treatment for patients under 18 and private treatment to adults and children.

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

The dental team includes one dentist, a practice manager, two dental nurses and one receptionist. The practice has one treatment room.

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 11 CQC comment cards filled in by patients. All feedback provided was highly positive.

During the inspection we spoke with the dentist, the practice manager, the receptionist and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from 9am to 1pm, and from 2pm to 5.30pm Monday to Friday.

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, with the exception of one item.
• 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 availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council. In particular, the stock of adrenaline pens and child size self inflating oxygen bag and reservoir, and the frequency of checks on this equipment.
• Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice. In particular, the recording of patients’ treatment options, risks and benefits, as discussed with the patient at consultation.

We spoke with four people who used the service on the day of inspection. They told us they were very happy with the service provided. Comments included "The staff are very good and helpful", "I am very happy with the dentist", "The staff are brilliant" and "I like the way the dentist explains things. He is very nice." All the people we spoke with confirmed the surgery is always clean and well maintained and that no one had any worries or concerns about the service.

Staff commented "The staff team is small and we all get on well together", "The provider and practice manager are very nice and supportive", "The training is good" and "The support here is good."

We looked at records and found them to be completed accurately and secure. Treatment plans were discussed and agreed with the patient prior to treatment taking place. Staff were trained in emergency procedures and emergency equipment was checked and accessible. There were appropriate policies, procedures and risk assessments in place that were reviewed by the practice manager.

We found the practice was compliant with the essential quality requirements of the Health Technical Memorandum 01-05: Decontamination in primary dental care practices (HTM 01-05). This is designed to assist all registered primary dental care services meet satisfactory levels of decontamination and evidence was seen of the practice having undertaken regular audits which demonstrated compliance