We carried out this announced inspection on 9 April 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

Westgate Dental Practice is in Warwick and provides NHS and private treatment to adults and children. The services are provided under two Care Quality Commission registered providers at this location. This report only relates to the provision of general dental care provided by Westgate Dental Practice. An additional report is available in respect of the general dental care services which are registered under Mr James Clark.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available in pay and display car parks near the practice.

The dental team includes five dentists including a foundation dentist, five dental nurses including an apprentice dental nurse, one dental hygienist, two receptionists, a compliance lead and a practice manager. The practice has six 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 Westgate Dental Practice is the principal dentist.

On the day of inspection, we collected 25 CQC comment cards filled in by patients.

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

The practice is open:

Monday from 8am to 7pm.

Tuesday to Thursday from 8am to 5pm.

Friday from 8am to 1pm.

Saturday by appointment only.

Our key findings were:

• The practice appeared clean and well maintained. The provider had a refurbishment plan in place and had recently replaced the ground floor treatment room flooring.
• 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 medicine which was out of date. The out of date medicine was retained due to a national shortage.
• 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. They routinely referred patients to their dental hygienist through a clear clinical care pathway.
• The appointment system took account of patients’ needs. The practice offered extended hours appointments for patients opening until 7pm on Monday; and opening on Saturday by appointment only.
• The provider had effective leadership and a culture of continuous improvement. Training and development was at the forefront in this practice due to the principal dentist being a verified trainer to support newly qualified foundation dentists. In house training for basic life support and fire safety was funded alongside online training.
• Staff felt involved and supported and worked well as a team. Staff we spoke with told us they enjoyed their work and were proud to work at the practice.
• 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 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 waste handling protocols to ensure waste is securely stored in compliance with the relevant regulations and taking into account the guidance issued in the Health Technical Memorandum 07-01.