We carried out this announced inspection on 21 November 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.

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

City Health Care Dental Services - Goole Health Centre provides NHS and private treatment to adults and children. They also hold an NHS contract to provide community dental services, but this service is currently not operating.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including for blue badge holders, are available near the practice.

The dental team includes two dentists, three dental nurses, a practice manager and one dental support worker. They are supported by a team of managers. The practice has four treatment rooms.

The practice is owned by a company 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 City Health Care Dental Services - Goole Health Centre is the Chief Executive.

On the day of inspection, we collected 10 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist, two dental nurses, one dental support officer, the practice manager and members of the wider management team. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday from 8:30am to 5pm

Friday from 8:30am to 4:30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance. Minor improvements could be made to the process.
• 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 practice staff 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.
• The provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• 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 provider had systems to deal with complaints positively and efficiently. Improvements could be made to the process to categorise and respond to these.
• 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.
• Review the practice's policy for the control of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.
• Review the process for ensuring equipment is maintained according to manufacturer’s guidance.
• Review the practice's complaint handling procedures. In particular, the system for identifying, handling and responding to complaints by service users

We saw evidence of how the provider used patient surveys and feedback to inform improvements to the service. Feedback was mostly complimentary and we saw examples of compliments on feedback cards.

We saw that the practice had a system for gaining consent and that forms were consistently completed. People's medical history and requirements informed the planning of care and treatments duly recorded. Emergency drugs were appropriate and available, and we saw other examples of the practice following published guidance.

The premises were clean and there were systems to minimise the risk of infection. The surgery rooms had clinical hand wash sinks that were not to the prevailing standard but were adequate for use. We saw examples of refurbished surgeries owned by the provider and were assured that refurbishment included design to the prevailing clinical standards.

Staff received regular training and supervisory support. The provider had a system for quality assurance and monitoring and we saw evidence that this was used to inform management decisions and policy review.