We carried out this announced inspection on 14 November 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 who was supported by a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

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

Hurworth Dental Surgery is located in Hurworth and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes the principal dentist, an associate dentist, two dental nurses, a secretary and one receptionist.

The practice has two treatment rooms, each with their own decontamination and sterilisation room (where cleaning and sterilising of dental instruments is carried out).

There is also a dedicated room for taking Orthopantomograms (OPG), a type of X-ray which shows the upper and lower jaws and surrounding structures.

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 Hurworth Dental Surgery was the principal dentist.

On the day of inspection we collected 67 CQC comment cards filled in by patients which gave us a positive view of the practice.

During the inspection we spoke with the principal dentist, two dental nurses and the receptionist.

We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday, Tuesday and Thursday 0900 to 1700

Wednesday 0900 to1800

Friday 0900 to1230

Our key findings were:

• The practice was clean, well maintained and had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies and 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.
• 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 had effective leadership. Staff felt 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.

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

• Review the practice’s Legionella risk assessment taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’
• Review the practice’s responsibilities with regards to the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and ensure risk assessments are carried out for all products held.
• Review the practice's current OPG X-ray and record keeping audit protocols to ensure they are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice and appraisals are carried out at regular intervals for all staff.

During this visit we spoke with three patients who were receiving treatment at this dental practice. All of those people had positive comments to make about the service they received.

One person told us; “It’s a very personalised service, you feel like a welcome friend”.

We saw there were systems in place to assure the quality of the service provided as well as manage decontamination and infection control processes so the safety of staff and patients was maintained.

Patients told us they felt there care and treatment was explained very well to them and we saw clear and detailed electronic records to confirm this.

Staff said they felt supported working at the service and there was regular training and meetings to discuss clinical and professional issues at the surgery.