We carried out this announced inspection on 30 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

Clavell-Bate & Nephew - Worsthorne is in Burnley, Lancashire and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Some car parking is available at the practice, with further on-street parking nearby.

The dental team includes the principal dentist, two dental nurses, one of whom is a trainee, and one visiting dental hygienist. The practice had two treatment rooms, a decontamination suite, a children’s waiting area, a reception office and a general patient waiting room.

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 Clavell-Bate & Nephew is the partner dentist, who works at the sister practice located in Whalley.

On the day of inspection, we collected 35 CQC comment cards filled in by patients. All feedback provided was positive.

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

The practice is open Monday 8am to 6pm, Wed from 9am to 6pm, Thursday from 9am to 6pm and on approximately one Friday per month from 9am to 3pm.

Our key findings were:

• The practice appeared clean and well maintained.
• Overall, the provider had infection control procedures which reflected published guidance.
• The Legionella assessment in place required review, to take account of the updated water system at the practice.
• 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 understood 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 a 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 any 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 Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’

• Review the practice's protocols for medicines management and ensure all medicines are dispensed safely and securely. In particular, ensure that all required information is provided on a label on dispensed items.

During the visit we spoke with three people (patients) who used the service. They told us they were happy with the service they received and staff were 'kind', 'professional', 'patient' and 'understanding'. One person said, "I am very happy with the service; I wouldn't come back if I wasn't".

People told us they were provided with information about the treatments and the costs and they had been given enough time and information to make a decision about their treatment. Comments included, "I ask questions and I get an honest answer" and "Everything is fully discussed with me".

The people that we spoke with made positive comments about the staff team. They described them as 'kind', 'understanding', 'patient' and 'professional'. We spoke with two members of the staff team. They told us, "I enjoy working here" and "I get the training and support that I need to do my job".