We carried out this announced inspection on 16 January 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.

We told the NHS England area team that we were inspecting the practice. We did not receive any information of concern from them.

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

East Road Care Limited is in Longsight, Manchester and provides NHS and private treatment to adults and children.

The dental practice is located on the ground floor premises of a terraced property. Access to the service is via the side entrance of the premises. A ramp facilitates access for people who use wheelchairs and pushchairs. On street parking spaces is available near the practice.

The dental team includes one dentist and two dental nurses who also carry out reception and administrative duties. The practice has one treatment room.

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 East Road Care Limited was the dentist.

On the day of inspection we collected 40 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday to Friday 9am to 6pm. The service is closed from 1 to 2pm each day for lunch.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• The practice had some systems to help them manage risk. The risks relating to fire safety were not adequately assessed.
• Staff received training in emergency resuscitation and basic life support every year. Staff lacked awareness of emergency equipment and protocols despite their training.
• The practice had safeguarding policies but staff did not have an effective process to raise concerns.
• Staff were not aware of the Mental Capacity Act, Gillick competence, the Duty of Candour or RIDDOR, or their responsibilities in relation to them.
• 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 appointment system met patients’ needs.
• The practice asked staff and patients for feedback about the services they provided.

There were areas where the provider could make improvements and should:

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review the storage of medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and Gillick competency, ensuring all staff are aware of their responsibilities under the Act as it relates to their role.