We carried out this announced inspection on 9 May 2017 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 with remote access to a specialist dental adviser.

We told the NHS England Cheshire and Merseyside area team and Healthwatch 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

Gental Dental Care is close to the centre of Widnes and provides treatment to patients of all ages on an NHS or privately funded basis.

There is a ramp at the entrance to facilitate access to the practice for wheelchair users. Car parking is available in the practice’s private car park.

The dental team includes three dentists, four dental nurses, and an apprentice dental nurse. The dental nurses also carry out reception duties. The practice has three treatment rooms.

The practice is owned by a partnership and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Gental Dental Care is the principal dentist.

We received feedback from 48 people during the inspection about the services provided. The feedback provided was positive about the practice.

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

The practice is open: Monday, Wednesday, Thursday 8.00am to 5.00pm, Tuesday 8.00am to 7.00pm, and Friday 8.30am to 3.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had systems in place to help them manage risk but improvements were needed in relation to mitigating some risks.
• Staff knew how to deal with emergencies. Not all medical emergency medicines and equipment were available in accordance with the recognised guidance.

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

• Review the practice’s system for assessing, monitoring and mitigating the various risks arising from undertaking of the regulated activities, specifically in relation to staff working in a clinical environment where their immunity to the Hepatitis B virus is unknown.
• Review the availability of equipment to respond to medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK), and the General Dental Council.
• Review the security of NHS prescription pads in the practice.
• Review the protocols and procedures for the use of X-ray equipment taking into account the recognised guidance on the safe use of X-ray equipment, specifically in relation to working instructions.