We carried out this announced inspection on 28 June 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.

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

Whitehouse Dental Surgery is located in Leicester and provides mostly NHS treatment to adults and children. The practice also offers some private dental treatment options.

There is level access for people who use wheelchairs and those with pushchairs with use of a ramp. Car parking facilities are not currently available for patient use; a rear car park was in the process of being built at the time of our visit. We were informed that the car park would include allocated parking for blue badge holders. Car parking spaces are available on side streets surrounding the practice.

The dental team includes eight dentists, one foundation dentist, one oral surgeon, one orthodontist, five dental nurses, one oral surgery nurse, three trainee dental nurses, a clinical lead, director, practice manager, deputy practice manager and a head receptionist who was qualified as a dental nurse.

The practice is an approved training practice for dentists new to general dental practice. One of the dentists is a trainer.

The practice list size included around 21,282 patients.

The practice holds contracts with NHS England to provide intermediate minor oral surgery, pathway orthodontics and out of hours care for patients triaged through NHS 111.

The practice has seven treatment rooms; two of which are on the ground floor.

The practice’s premises have been undergoing extensive refurbishment. An extension has been built to accommodate new office space as well as a staff kitchen. A new decontamination room has been installed. Four new surgeries have been built within the last 12 months. Further refurbishment was ongoing at the time of our inspection.

The practice is owned by a company 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 Whitehouse Dental Surgery is the practice manager.

On the day of inspection we collected 28 CQC comment cards filled in by patients.

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

The practice is open Mondays and Thursdays from 9am to 8.30pm, Tuesdays, Wednesdays and Fridays from 9am to 5pm and Saturdays from 9am to 1pm. The practice closes for lunch between 1pm and 2pm on weekdays.

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 practice staff 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.
• The provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice 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.

We spoke with four patients who attended the surgery on the day of our inspection. They told us they were happy with the treatment they received at the surgery.

They told us that dentists explained treatment options and any costs involved before any treatment began. They were always treated politely and with respect.

One patient told us, “I’ve been a patient since I was a child. My parents brought me here, and I’ve brought my own children although we don’t live that near anymore.”

We found that staff were appropriately trained and supervised. They understood their responsibilities about keeping children and vulnerable adults safe from harm.

The provider ensured that high standards of hygiene and infection control were maintained throughout the surgery.

The provider had systems in place to assess and maintain the quality of the service and to obtain feedback from patients.