We carried out this announced inspection on 7 November 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

Leamington Road Dental Practice is in Coventry and provides private treatment to adults and children.

The practice is in a residential area and the treatment rooms are situated on the first floor; these are accessible by a flight of stairs. The practice informs all new patients intending to register that their premises are not wheelchair accessible. They signpost patients that cannot climb the stairs to a nearby practice. Car parking spaces are available in the dedicated car park at the front of the practice and also on the streets surrounding the practice.

The dental team includes two dentists, three dental nurses and a practice administrator. The practice has two 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 Leamington Road Dental Practice is the principal dentist.

On the day of inspection, we collected 22 CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with two dentists, two dental nurses and the practice administrator. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday from 8.30am to 5pm.

Wednesday from 9am to 6.30pm.

Thursday from 9am to 4.30pm.

Friday from 9am to 3pm.

Our key findings were:

• The provider was a new owner of the practice and registered with the Care Quality Commission (CQC) less than four months prior to our visit. They were in the process of updating existing equipment, embedding new policies and procedures and implementing new systems.
• The practice appeared clean and well maintained.
• The provider had infection control procedures which mostly reflected published guidance. We were not provided with weekly and quarterly ultrasonic bath checks or servicing details.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk to patients and staff. However, there was scope for improvement in relation to domiciliary visits, radiation protection and recording equipment and safety checks. Improvements were made following our visit.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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 provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and was embedding a 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. Information from 22 completed CQC comment cards gave us a positive picture of a friendly, professional and high-quality service.
• The provider had not received any complaints but had processes in place to deal with any should the need arise.
• The provider had suitable information governance arrangements.

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

• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular ensuring the ultrasonic bath is serviced in line with manufacturers requirements and that weekly and quarterly tests are recorded.

• Review the practice's Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’ In particular ensuring staff have completed legionella training and that monthly temperatures for sentinel taps are recorded.

• Review the practice’s protocols for domiciliary visits taking into account the 2009 guidelines published by British Society for Disability and Oral Health in the document “Guidelines for the Delivery of a Domiciliary Oral Healthcare Service”.