We carried out this announced inspection on 14 August 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

Dental Practice, also known as Church Road Dental Practice is in Wavertree, Liverpool and provides NHS and private treatment for adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking is available on the road outside the practice. There is a small area in front of the practice where patients with reduced mobility can park but these are not marked as car parking spaces for disabled people.

The dental team includes two dentists, three dental nurses, one dental hygienist, and one practice manager. The practice has three treatment rooms, one on the ground floor and two on the first floor.

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 28 CQC comment cards filled in by patients. All feedback received was highly positive.

During the inspection we spoke with the principal dentist, 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 on Tuesday and Thursday from 8am to 1pm. On Monday the practice is open from 9am to 1pm and from 2pm to 5.30pm. On Wednesday, the practice is open from 8.30am to 1pm and from 2pm to 5.30pm and on Friday from 9am to 3pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment was available.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff understood their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place.
• 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 practice 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 practice staff had systems in place to deal with complaints efficiently.
• The practice staff had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice’s protocols to ensure antibiotic prescribing audits are undertaken at recommended intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

• Review the security of NHS and private prescription pads in the practice and ensure there are systems in place to track and monitor their use, and review labelling of dispensed medication to ensure this complies with legislation and considers current guidance.
• Review the practice's record keeping relating to people employed.

We spoke with four people during our inspection who all told us they were happy with the care and treatment they had received at the Dental Practice. Some comments made were:

“I wouldn’t like to have to find another dentist; you wouldn’t find one as good as them”.

“They make me feel relaxed, and I’m nervous about the dentist”.

“I couldn’t find fault with anyone here, they are all smashing”.

During our visit we saw that the treatment rooms, decontamination room, waiting area and other communal areas were clean and tidy. We also saw that the instruments and equipment used at the practice were cleaned and decontaminated in line with current best practice guidance.

People who used the service were given clear information about the treatment they would receive and how much it would cost. There were suitable arrangements in place to deal with foreseeable emergencies and all staff had been provided with suitable training and support with which to undertake their roles and responsibilities.