We carried out this announced inspection on 8 April 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

Blanc Dental Care is in Todmorden and provides NHS and private treatment to adults and children.

The practice has a portable ramp to facilitate access to the practice for wheelchair users. Car parking is available near the practice.

The dental team includes three dentists, four dental nurses, one dental hygienist, one dental hygienist / therapist and one receptionist. The practice has three 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 Blanc Dental Care is one of the partners.

On the day of inspection, we collected 45 CQC comment cards filled in by patients.

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

The practice is open:

Monday and Thursday from 8:50am to 5:15pm

Tuesday from 8:50am to 5:45pm

Wednesday from 8:50am to 4:15pm

Friday from 8:50am to 3:15pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures. Improvements could be made to some of the processes relating to the decontamination procedures.
• 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. Improvements could be made to the process for managing he risks associated with fire.
• 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.
• 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 infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices. In particular, the use of transportation boxes for sterilised instruments and carrying out the steam penetration test when the autoclave is used on a vacuum cycle.
• Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children.
• Review the fire safety risk assessment and ensure that emergency lighting arrangements are in place.

We spoke with one patient who was waiting for treatment. They told us they had received a treatment plan and knew what treatment they required. They told us they were happy with the service provided.

We looked at four electronic patient records and saw they contained information about the treatment provided and oral health given. We also saw signed copies of treatment plans and NHS FP17 forms demonstrating people gave consent to their treatment.

The practice was clean and hygienic. We saw evidence that equipment was sterilised to the appropriate standards.