We carried out this announced inspection on 5 February 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

Alkrington Dental Practice is in Middleton, Manchester and provides private treatment to adults and a small percentage of children.

There is a small step into the practice, a portable ramp is available for people who use wheelchairs and those with pushchairs to gain access if required. Car parking is available outside the practice.

The dental team includes one dentist, four dental nurses (one of whom is a trainee) and the dental hygiene therapist/practice manager (who is the owner of the practice). The practice has two treatment rooms and a preventative dental unit treatment room (oral health education facility). A third treatment room is occupied by a Podiatrist who works there on a self-employed basis.

The practice is owned by an individual who is the dental hygiene therapist/practice manager there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 33 CQC comment cards filled in by patients. All of which showed patients had a positive experience at the practice.

During the inspection we spoke with the dentist, three dental nurses and the dental hygiene therapist/practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday and Wednesday 9:30pm – 5:30pm

Thursday 9:30am – 7pm

Friday 08:30am – 12:30pm

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. We found areas where improvements could be made.
• 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.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• No process was in place to monitor patient referrals.
• Staff felt involved and supported and worked well as a team.
• 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 practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular: the manual cleaning of dental instruments and the Control of Substances Hazardous to Health.
• Review the practice’s system for recording incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities in relation to this.
• Review the practice’s processes and ensure a log is implemented to monitor the progression of patient referrals.