We carried out this announced inspection on 11 December 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. We did not receive any information of concern from them.

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

530 Bolton Partnership is in Bolton and provides NHS and private treatment to adults and children.

A portable ramp is available for people who use wheelchairs and pushchairs. On street parking is available near the practice.

The dental team includes four dentists, seven dental nurses (one of whom is a trainee), two dental hygienists and a practice manager. The practice has four 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 530 Bolton Partnership was the practice manager.

On the day of inspection we collected seven CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday to Thursday 8am to 7pm

Friday 8am to 5pm

Our key findings were:

• The practice was 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 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 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 and should:

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

We carried out a comprehensive inspection of this practice on 17 September 2015. Breaches of legal requirements were found. After the inspection, the practice wrote to us to say what they would do to meet legal requirements in relation to good governance and safeguarding service users from abuse and improper treatment.

We undertook this focused inspection to check that they had followed their plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for 530 Bolton Partnership on our website at www.cqc.org.uk.

Our findings were:

Are services safe?

We found that this practice was providing safe 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

530 Bolton Partnership (part of Oasis Dental Care) took over the ownership of the practice in December 2014. The practice provides private and NHS dental treatments to children and adults living in the Bolton area of Greater Manchester. The practice offers a range of dental services including examinations, assessments, individual treatments and dental hygiene. The staff in the practice consists of four dentists, two dental hygienists and six dental nurses. There was also a practice manager, a receptionist and an apprentice dental nurse. The practice opening hours are from 8.00am to 6.00pm Monday to Friday. Appointments are from 8.30am to 5.30pm on a Monday, Thursday and Friday, with extended hours being provided between 5.30pm and 7.00pm on a Tuesday and Wednesday.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• Staff had completed safeguarding training in relation to children and vulnerable adults.
• Staff appraisals had taken place.
• Staff were up to date with their continuing professional development and this was being monitored by the practice manager to ensure all mandatory training was completed.

We carried out an announced comprehensive inspection on 17 September 2015 to ask the practice the following key questions; are services safe, effective, caring, responsive and well-led?

Our findings were:

Are services safe?

We found that this practice was not 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 not providing well-led care in accordance with the relevant regulations.

Background

530 Bolton Partnership (part of Oasis Dental Care) took over the ownership of the practice in December 2014. The practice provides private and NHS dental treatments to children and adults living in the Bolton area of Greater Manchester. The practice offers a range of dental services including examinations, assessments, individual treatments and dental hygiene. The staff in the practice consists of four dentists, two dental hygienists and six dental nurses. There was also a practice manager, a receptionist and an apprentice dental nurse. The practice opening hours are from 8.00am to 6.00pm Monday to Friday. Appointments are from 8.30am to 5.30pm on a Monday, Thursday and Friday, with extended hours being provided between 5.30pm and 7.00pm on a Tuesday and Wednesday.

There is a registered manager in place, although they were not present at the inspection. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We reviewed 14 comment cards that had been completed by patients and carried out two telephone interviews with two patients. Patients indicated they were very happy with the service provided. They described the dentists as excellent and professional and the support staff as caring and friendly. Patients commented that they were given oral health care advice and their treatments were always fully explained.

Our key findings were:

• The practice was not following national guidance in the use of rubber dams for root canal treatments.

• The practice worked with other providers to ensure that co-ordinated care was provided.

• Emergency equipment was stored in different places around the practice so may not be easily available in the event of an incident occurring.

• Regular practice meetings took place to ensure good communication among the staff team

• There were no evidence of staff appraisals having taken place.

• It was not possible to clearly establish the training staff had completed as some staff training records were incomplete.

• Staff said they enjoyed their work and felt well supported in their role.

• Staff had not completed safeguarding training and a recent safeguarding incident had not been reported to the local authority.

• There were limited governance procedures in place at the practice.

We identified regulations that were not being met and the provider must:

• Ensure that all of the staff have undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.

• Ensure suitable governance arrangements are in place and an effective system is established to assess, monitor and mitigate the various risks arising from undertaking of the regulated activities.

You can see full details of the regulations not being met at the end of this report.

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

• Review the practice's protocols for completion of dental care records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.

• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.

• Review the storage of records relating to people employed and the management of regulated activities giving due regard to current legislation and guidance.

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

• Review the storage of dental care products requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.