We carried out this announced inspection on 21 May 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

EMCDA LTD is in Hull and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. The practice has a car park with dedicated spaces for blue badge holders.

The dental team includes five dentists (two of whom are locums), six dental nurses (two of whom are trainees), one dental hygienist, three receptionists and a practice manager. The practice has five 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 EMCDA LTD was one of the directors.

On the day of inspection, we collected 68 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, three dental nurses, two receptionists 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 8:30am to 6:30pm

Our key findings were:

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

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

• Review the practice’s system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the practice’s protocols to ensure audits have documented learning points and the resulting improvements can be demonstrated.

During the visit we spoke with seven people in the waiting room. All the people spoken with told us the dentist always discussed their treatment and explained options and fees to them. They all confirmed they signed consent to treatment forms.

People confirmed during visits they had an oral examination and a treatment plan was discussed with them. They said they completed health questionnaires and were asked to update these regularly.

People were very happy with the care and treatment they had received from the practice. They told us they were treated with respect and that staff were friendly. One person told us the dentist checked their treatment plan with their GP because of their medical condition. They also said that the practice was aware of their allergy to latex and used non-latex gloves when treating them.

Comments included, “I’m happy with the service, I can’t fault it”, “She was very nervous but they explained everything and what was going to happen and she was fine” and “I prefer to come here even though it’s not my nearest dentist.”

People spoken with confirmed they had observed staff wearing aprons, gloves and masks. They told us the surgeries were clean and tidy.