We carried out this short notice announced inspection on 31 October 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We visited the practice following concerns that had been raised with us regarding patient care and staff support. 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

First Dental Care is in Denton on the outskirts of Manchester and provides NHS and private treatment for adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Public parking and public transport facilities are available near the practice.

The dental team includes four dentists, two dental hygienists, four dental nurses and two receptionists. The practice has three 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 the practice is the principal dentist.

During the inspection we spoke with two dentists (including the principal dentist), one hygienist, two dental nurses and two receptionists. We looked at the practice’s policies and procedures and other records about how the service is managed.

The practice is open: Monday and Thursday 9am - 6pm, Tuesday 8am-4:30pm, Wednesday 9am- 5:45pm and Friday 8am-3:30pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available with the exception if the portable suction
• The practice had systems to help them manage risk.
• The provider had staff recruitment procedures in place.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• 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 staff had suitable information governance arrangements.

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

• Review the practice's Legionella risk assessment and re-introduce monthly water temperature testing of the sentinel outlets.
• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to all new staff commencing employment at the practice for instance (Disclosure and Barring Service), (DBS) checks.
• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council for example the addition of portable suction.