We carried out this announced inspection on 24 October 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

Wotton Road Dental care is a small, well-established practice in Kings Lynn that provides NHS treatment to patients. The dental team includes two dentists, a hygienist, two nurses, two receptionists and a practice manager. It has three surgeries.

The practice opens on Mondays to Thursday from 9 am to 6pm; and on Fridays from 9am to 5pm. There is level access for people who use wheelchairs and those with pushchairs. On road parking is available near the practice.

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 is the practice manager.

On the day of inspection, we collected seven CQC comment cards completed by patients, and spoke with another two. We spoke with the practice manager, one dentist, a hygienist, two nurses and the receptionist. We also spoke with the provider’s regional and compliance managers who were also on site. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice had effective systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and responding to medical emergencies.

• Risk assessment was robust and action was taken to protect staff and patients, although recommendations from the legionella risk assessment in relation to water line flushing needed to be implemented.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.

• The practice asked staff and patients for feedback about the services they provided,

• The practice had experienced difficulties in recruiting dentists and this had adversely affected the continuity of care, the availability of appointments for patients and the length of time to complete a course of treatment.
• Prescription pads were held securely but there was no tracking in place to monitor individual prescriptions and identify any individual theft or loss

There were areas where the provider could make improvements and should:

• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review appraisals systems to ensure all staff receive regular feedback about their performance.