We carried out an announced comprehensive inspection on 8 February 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Eccleston Dental Practice is located in the village of Eccleston, on the outskirts of Chorley. The practice is accessed from the rear of the building. All facilities are located on the upper floor of the building accessed by a staircase. The practice provides a full range of treatments for those using National Health Services (NHS) and private treatments are also available if required. Two dentists, two dental hygienists and five dental nurses work at the practice. Because access to the practice is limited for patients with restricted mobility then visits to patients in their own home are provided. The practice is open from 9.00am to 4.00pm Monday to Friday.

The practice owner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We reviewed 45 CQC comment cards on the day of our visit and spoke with three patients during the inspection. Patients spoke highly of the staff and the standard of care provided by the practice. Patients commented that they felt involved in all aspects of their care and found the staff to be helpful, respectful, and friendly, and said they were treated in a clean and tidy environment.

Our key findings were:

• The practice was well organised, visibly clean and free from clutter.
• An infection prevention and control policy was in place. Sterilisation procedures followed Department of Health guidance.
• The practice had systems for recording incidents and accidents.
• The practice had a safeguarding policy and staff were aware on how to escalate safeguarding issues for children and adults should the need arise.
• Staff received annual medical emergency training. Equipment for dealing with medical emergencies reflected guidance from the resuscitation council (UK).
• Dental professionals provided treatment in accordance with current professional guidelines.
• A process was in place to seek patient feedback about the service.
• Patients could access urgent care when required.
• Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
• A process was in place for managing complaints.
• The practice was actively involved in promoting oral health.
• Recruitment checks were not complete for all staff.
• Risk assessments for products hazardous to health were not in place.

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

• Review the practice's recruitment policy and procedures to ensure appropriate recruitment checks are undertaken for staff.
• Review arrangements for the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and ensure risk assessments are in place for all hazardous products.
• Review the policy for undertaking domiciliary visits to ensure risks are effectively managed, including the arrangements for responding to a medical emergency.

We spoke to a range of people about the service. They included, a dentist, who was also the registered manager, dental nurse, receptionist and patients receiving treatment, in order to gain a balanced overview of what people experienced.

During our discussions with patients we received positive feedback. They told us they were happy with the care and support shown to them during the course of their treatment.

Comments from patients included:

"Every time I visit I am treated well. It is a friendly place. They (the staff) put me at ease when I am nervous before treatment."

"I have been coming here for years. Ever since it opened. I don't even live in the area any more, but I continue to come here for my dental care, as I am happy with the treatment I receive from everyone."

"I am always told what needs doing and how much it is going to cost me."