We carried out this announced inspection on 24 October 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.

We told the NHS England area team that we were inspecting the practice. They provided information which we took into account.

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

Yarde House Partnership is in Taunton town centre and provides NHS treatment to patients of all ages.

There is a small step upon access to the building. There is a ramp available for patients who use wheelchairs and pushchairs. There is no patient car parking. Local transport services are available and pay and display car parks nearby.

The dental team includes three dentists, five qualified dental nurses, two trainee dental nurses, one dental hygienist and six receptionists. The practice has seven treatment rooms, four of which were currently in use.

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 Yarde House Partnership was the practice manager.

On the day of inspection we collected six CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, three dental nurses, two receptionists, the practice manager and the area and compliance managers. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Friday from 8:15am to 5:15pm
• Saturdays from 8:30am to 12:30pm with one Saturday per month with later opening till 3:30pm
• Out of hours dentistry was covered by NHS 111 service

Our key findings were:

• The practice appeared clean and well maintained.
• The practice 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.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures which should be improved.
• 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.
• 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 the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Introduce protocols regarding the prescribing and recording of antibiotic medicines taking into account guidance provided by the Faculty of General Dental Practice in respect of antimicrobial prescribing.
• Review the current Legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures.
• Review the practice’s systems for analysing the results of audits and reviews to identify, share and act on areas for improvement where appropriate.
• Review the staff supervision protocols and ensure an effective process is established for the on-going appraisal of all staff