We carried out this announced inspection on 12 March 2019 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

Manor Road Dental, Woolton is in South Liverpool and provides private treatment to adults and children.

The practice is not suitable for people with limited mobility as there is no level access. Those people who have pushchairs or prams may also find access to the surgery difficult. Car parking spaces are available near the practice.

The dental team includes two dentists and one dental nurse The practice has one treatment room.

The practice is owned by a partnership 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 Manor Road Dental, Woolton, is the principal dentist.

On the day of inspection, we collected 29 CQC comment cards filled in by patients. All feedback provided was highly positive.

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

The practice is open on Monday and Friday from 9am to 5pm and on Wednesday from 9am to 8pm. The practice is open on Tuesday but for administrative work only. If patients are in pain and need to be seen urgently, arrangements will be made to accommodate patients. The practice is not open to patients on Thursday. The practice closes for lunch between 1 and 2pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• A risk assessment for the control of Legionella was in place but this required review.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available except for an oxygen masks for use on children.
• The practice had systems to help them manage risk to patients and staff.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with any complaints or concerns positively and efficiently.
• The provider had suitable information governance arrangements. We discussed how the current system in place for patient referrals could be improved.

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

• 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, that the current risk assessment does not take account of all outlets and pipework on the current water system.
• Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular, clinical areas within the practice where flooring requires repair or replacement.

On the day of our inspection, there were no patients available for us to speak with at Manor Road Dental. However we saw evidence of returned questionnaires from people who used the service, which gave positive feedback. Some comments made were:

“Staff are all very professional”.

“I don’t like going to the dentist but I’m happy to come here”.

“Would recommend to friends and family”.

During our visit we saw that the treatment room, decontamination room, waiting area and other communal areas were clean and tidy. People who used the service were given clear information about the treatment they would receive and how much it would cost. There were suitable arrangements in place to deal with foreseeable emergencies and all staff had been provided with suitable training and support with which to undertake their roles and responsibilities.