We carried out this announced inspection on 17 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.

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

Weobley Dental Surgery is located in the village of Weobley and provides predominantly NHS services with private treatment options to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. The ground floor of the practice consists of a reception area, a waiting room, a patient toilet and three dental treatment rooms. On the first floor there is a decontamination room for the cleaning, sterilising and packing of dental instruments, a staff room, a kitchen and staff toilet facilities. Car parking spaces, including two for patients with disabled badges, are available outside the practice.

The dental team includes three dentists, four dental nurses, two receptionists and an administrator. The practice has three 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 Weobley Dental Surgery was the principal dentist.

On the day of inspection we collected 44 CQC comment cards filled in by patients and looked at the most recent patient survey undertaken in January 2017. Without exception patients were positive about the quality of the service provided by the practice. They gave examples of the positive experiences they had at the practice and told us the practice team were professional, caring and always involved them with their treatment options.

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

The practice is open:

Monday – 9am to 5.30pm

Tuesday – 9am to 7.30pm

Wednesday – 9am to 5.30pm

Thursday – 9am to 5.30pm

Friday – 9am to 5pm

The practice closes for lunch between 1pm and 2pm every day.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available although we found three airways were out of date.
• The practice had systems to help them manage risk. The practice had completed a legionella risk assessment however this did not highlight any required actions such as monitoring and recording of water temperatures.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures although ID was not kept on staff files.
• 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. We were informed appraisals had not been completed since 2014 but were scheduled for October 2017.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review stocks of emergency equipment and the system for identifying, disposing and replenishing of out-of-date stock.

• Review the practices’ current Legionella risk assessment and implement the required actions taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’

• Review the staff supervision protocols and ensure an effective process is established for the on-going appraisal of all staff.

As part of our inspection we spoke with four people who were at the practice for treatment when we visited and with six others by telephone. We met and spoke with all three dentists, three of the dental nurses, a receptionist and the practice administrator.

The people we talked with spoke highly of the dental practice. One person told us that their dentist was “very good indeed” and most commented on how friendly and flexible the practice was. This was described by one person as “informal but professional” and they added that they thought most people in the community would feel the same. It was clear that the practice was highly valued by the rural village community for providing a dental service close to where people lived.

People confirmed that they had been involved in making decisions about the dental care they received and were given clear information about treatment and the costs involved. People gave us examples of the treatment they had received which showed that their dental care had contributed to their overall health and well being.

There were arrangements in place to deal with emergency situations including annual training for all staff in first aid, resuscitation and the use of a defibrillator.

All of the dentists and nurses were qualified and registered with the General Dental

Council and therefore expected to work in accordance with their professional codes of practice.

Safeguarding information was available and included the arrangements for child and vulnerable adult protection.

The arrangements for the management of the practice took account of national guidance about safety in important areas such as the control of infection and the decontamination of instruments.

We found that the practice staff were friendly and welcoming and this was reflected in what people we spoke with told us. The staff we spoke with enjoyed working at the practice and felt well supported by their employers.