We undertook a focused inspection of Belford Dental Practice on 26 July 2018. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of Belford Dental Practice on 28 March 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing safe and well-led care in accordance with the relevant regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Belford Dental Practice on our website www.cqc.org.uk.

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

As part of this inspection we asked:

• Is it safe?

• Is it well-led?

Our findings were:

Are services safe?

We found this practice was providing safe care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 28 March 2018.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 28 March 2018.

Background

Belford Dental Practice is in Belford, Northumberland and provides 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 one dentist, one dental nurse and one receptionist. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist 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.

During the inspection we spoke with the dentist, the dental nurse and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9am to 6:30pm

Tuesday 9am to 4pm

Wednesday 9am to 5pm

Thursday 9am to 5pm

Friday 9am to 1pm

Our key findings were:

• Medicines and life-saving equipment were available in accordance with national guidance. The practice had purchased an Automated External Defibrillator.
• The practice had effective systems to help them manage risks associated with fire, legionella and other areas.
• The provider had thorough staff recruitment procedures.
• The practice staff understood their responsibilities in relation to the Control of Substances Hazardous to Health (COSHH) Regulations 2002.
• Staff had reviewed their protocols and procedures for use of X-ray equipment giving due regard to Guidance Notes for Dental Practitioners on the Safe use of X-ray Equipment by the National Radiological Protection Board.
• The practice had fully assessed the needs of all population groups in line with the requirements of the Equality Act 2010; a disability discrimination assessment was undertaken for the premises.
• Staff were aware of how to access an interpreter service for patients who do not speak English as their first language.
• The dental team was familiar with the requirements of the Mental Capacity Act 2005 as well as other recent guidance relating to dentistry.

We carried out this announced inspection on 28 March 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.

We carried out this inspection in response to information that was shared with us from the NHS England area team.

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 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

Belford Dental Practice is in Belford, Northumberland and provides 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 one dentist, one dental nurse and one receptionist. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist 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 17 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9am to 6:30pm

Tuesday 9am to 4pm

Wednesday 9am to 5pm

Thursday 9am to 5pm

Friday 9am to 1pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Improvements were needed to the medicines and life-saving equipment were available in accordance to national guidance. The practice did not have appropriate access to an Automated External Defibrillator.
• The practice did not have effective systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice did not have 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 asked staff and patients for feedback about the services they provided.
• The practice had systems to deal with complaints positively and efficiently.

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

• Ensure care and treatment is provided in a safe way to patients.

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the protocols and procedures for use of X-ray equipment giving due regard to guidance notes on the Safe use of X-ray Equipment.
• Review its responsibilities to the needs of people with a disability and the requirements of the equality Act 2010 and ensure a Disability Discrimination Act assessment is undertaken for the premises.
• Review the availability of an interpreter service for patients who do not speak English as their first language.
• Review staff awareness of the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.