We carried out this unannounced inspection on Wednesday 6 February 2019 under Section 60 of the Health and Social Care Act 2008 in response to receiving information of concern 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

Earby Dental Practice is in Barnoldswick and provides NHS and private treatment to adults and children.

A portable ramp is available for people who use wheelchairs and those with pushchairs. Car parking spaces and additional on-street parking are available near the practice.

The dental team includes the principal dentist, two dental nurses (one of whom manages the practice and one is a trainee), a part time dental hygiene therapist and a receptionist. The practice has three treatment rooms, only two of which are in use.

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 Earby Dental Practice is the principal dentist.

On the day of inspection, we spoke with five patients. They were positive about the staff and the service provided.

During the inspection we spoke with the principal dentist and both dental nurses. We also spoke with the dental hygiene therapist on the telephone as they were not present during the inspection. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday 09:00 - 13:00 and 14:00 - 18:00

Wednesday to Friday 09:00 - 13:00 and 14:00 - 17:30

Friday 09:00 - 13:00 and 14:00 - 17:30

Our key findings were:

• The premises were clean and well maintained.
• Minor improvements were needed to the infection control procedures.
• 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 with the exception of Disclosure and Barring Service (DBS) checks.
• 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 to ensure audits of infection prevention and control are undertaken at six monthly intervals to improve the quality of the service. The practice should also review the processes to ensure instruments are dried before pouching and identifying when instruments should be reprocessed.

• Review the practice's policies and procedures for obtaining patient consent to care and treatment to ensure they are in compliance with legislation, take into account relevant guidance, and staff follow them.

• Review the practice's protocols for patient assessments and ensure they are in compliance with current legislation and take into account relevant nationally recognised evidence-based guidance. In particular, taking radiographs prior to endodontic treatment.

• Review the system to ensure there are systems in place to track and monitor the use of NHS prescription pads.