We carried out this announced inspection on 11 February 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

Dental Care Centre is in Mirfield and provides NHS and private treatment to adults and children.

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

The dental team includes three dentists, five dental nurses (three of whom cover reception duties), one dental hygienist and a practice manager. 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 Dental Care Centre is the practice manager

On the day of inspection, we collected 19 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, one dental nurse 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 from 9:00am to 5:00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures. Minor improvements could be made to some processes.
• Staff knew how to deal with emergencies. The contents of the medical emergency kit did not reflect that of nationally recognised guidance.
• 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 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 patients for feedback about the services they provided.
• The provider had an accessible complaints procedure.
• 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: with regards to the changing of heavy duty gloves and the use of lockable boxes for transporting instruments.
• Review the process for storing patient’s complaints so they are separate from their individual dental care records.
• Review the process for maintaining confidentiality by keeping surgery doors closed when patients are receiving treatment.

We spoke with one person in the reception area who was waiting to see the dentist. They told us they were happy with the service and staff were nice.

We spent a significant proportion of our time discussing the practice procedures in quality management and recruitment with the registered manager. We were happy with the procedures in place for monitoring the quality of service and recruiting staff.

We spoke with two dental nurses about infection prevention and control procedures. They were able to demonstrate that procedures were in place and being followed to reduce the risk of infection. We looked around the dental practice including three treatment rooms and the room used for the decontamination of dental equipment; they were clean.

We looked at the electronic dental care records of five people, which included children. We saw evidence that consent was sought prior to treatment and the dentists had explained why treatment was or was not required. We saw from the care records that people's oral health needs were assessed and relevant clinical guidance and good practice was followed, for example, National Institute of Clinical Excellence guidance on patient re-call.