We carried out this announced inspection on 23 January 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

Brownley Green Dental Practice is in Wythenshawe and provides NHS and private treatment to adults and children.

The practice is located in a large health centre with other healthcare providers. There is level access for people who use wheelchairs and those with pushchairs. A car park is available, including spaces for blue badge holders.

The dental team includes the principal dentist and an associate dentist, three dental nurses of whom two are trainees, and a practice manager. The practice has two treatment rooms.

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 50 CQC comment cards filled in by patients. Patients were positive about staff, the premises and the services provided.

During the inspection we spoke with both dentists, two dental nurses 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 Friday 9am to 1pm and 2pm to 5pm.

Our key findings were:

• The premises were 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.

• 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 protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.

We carried out an announced comprehensive inspection on 8 March 2016 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 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

Brownley Green Dental Practice occupies a ground floor dental suite within Brownley Green Health Centre in a residential area of Wythenshawe in South Manchester. The premises have level access for people who have limited mobility and wheelchair users. There is a large shared waiting area and adapted toilet facilities are provided.

The practice provides routine examinations and treatment under an NHS contract to both adults and children. It is run by one dentist (the principal dentist) who is also the registered provider. Registered providers 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.

The staff group includes the principal dentist, an associate dentist, two senior dental nurses, two dental nurses, a trainee dental nurse and a practice manager. The dental nurses also cover reception duties.

The practice opening hours are Monday to Thursday 9.00am to 5.30pm and Friday 9am to 5pm. The practice closes for lunch each day from 1pm to 2pm.

We received feedback from 46 patients via CQC comment cards and through speaking with patients on the day of the inspection. The feedback from patients was overwhelmingly positive with comments such as: helpful and polite, needs catered for, professional, impeccable treatment and fantastic.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• The practice had access to an automated external defibrillator (AED) and medical oxygen was available on the premises. An AED is a portable device used to treat people in the event of a cardiac arrest. Staff had been trained to manage medical emergencies.

• Staff had received safeguarding training and knew the procedure to follow if they had any concerns about a patient’s safety.

• There were systems in place to check all equipment had been serviced regularly, including the steriliser, fire extinguishers, oxygen cylinder and the X-ray equipment.

• Staff recruitment policies were appropriate and relevant checks were completed. Staff received relevant training and were supported to maintain their continuing professional development (CPD). There were sufficient numbers of suitably qualified staff to meet the needs of patients.

• There were governance systems in place that included auditing of infection control, dental care records and radiographs (X-rays). The practice had ensured that risk assessments were in place and that they were regularly reviewed.

• The provider had emergency medicines in line with the British National Formulary (BNF) guidance for medical emergencies in dental practice.

• The practice carried out oral health assessments and planned treatment in line with current best practice guidance, for example from the Faculty of General Dental Practice (FGDP).

• Infection control procedures were in accordance with the published guidelines.

• Patients gave consent to treatment and they were provided with treatment plans. Patients commented that they were listened to and that they received good care from a helpful and caring team.

• Patients were treated with respect and confidentiality was maintained.

• Information about how to complain was available and easy to understand.

• New patients were asked to complete a medical history form that included information about allergies, general health and any medications they were taking. This was checked verbally at subsequent consultations to ensure nothing had changed.
• Patients were able to make routine and emergency appointments when needed. There were clear instructions for patients regarding out of hours care.

We spoke with people using this service on the day of our visit. They told us that they were very pleased with the care and treatment. They said the staff were very caring, supportive and treated them with respect.

They told us the practice was clean and easy to access. They said that they could always

get emergency appointments and never waited too long to see the dentist at their

appointments. They felt that their privacy was always maintained.