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 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

Newton Dental is in a suburb of Newton-le-Willows and provides NHS and private dental care for adults and children.

The provider has installed a ramp to facilitate access to the practice for wheelchair users and for pushchairs. Car parking is available near the practice.

The dental team includes a principal dentist, four associate dentists, two dental hygiene therapists, eight dental nurses, one of whom was a trainee, and a reception supervisor. The dental team is supported by a practice manager. The practice has five treatment rooms.

The practice is owned by 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 Newton Dental was the practice manager.

We received feedback from 42 people during the inspection about the services provided. The feedback provided was positive.

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

The practice is open:

Monday, Wednesday, Thursday 9.00am to 6.00pm

Tuesday 9.00am to 8.00pm

Friday 9.00am to 3.00pm

Saturday 9.00am to 2.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available. Insufficient medical emergency oxygen was available at the practice.
• Staff provided patients’ care and treatment in line with current guidelines.
• The dental team provided preventive care and supported patients to achieve better oral health.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took account of patients’ needs.
• The provider had a procedure in place for dealing with complaints. The practice dealt with complaints positively and efficiently.
• The practice had a leadership and management structure.
• The provider had systems in place to manage risk.
• Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.

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

• Review the practice's protocols and procedures to ensure compliance with the Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment, specifically to ensure all dentists consistently justify and report on X-rays taken.
• 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, specifically in relation to ensuring sufficient medical emergency oxygen is available.
• Review the arrangements for ensuring the practice’s systems for monitoring the quality and safety of the service are effective, in particular in relation to auditing, and to the monitoring of accident records.

We spoke with two patients who were receiving treatment at the practice on the day of our inspection. Both patients told us they were happy and satisfied with the treatment they had received so far.

Some of their comments were, “I have been a patient here for nearly five years. It’s very good”, “The staff are brilliant at putting you at ease. I would recommend the practice to anyone”,” They always give me advice and information about my treatment or potential treatment”, “The reception staff are really good. Today I managed to get an appointment for my partner at short notice. Very convenient and accommodating” and “They go through everything and tell me what’s going to happen at my next visit and I am always asked if the treatment was okay”.

We observed members of staff interacting with patients in a polite, professional and courteous manner.

The practice had various leaflets available and posters on view, giving information and advice about the services being provided including, health issues, how to complain and information regarding the safeguarding of children and adults (for members of staff and for patients).

During our visit Newton Dental we observed some positive interactions between members of staff and people using the service.

People (Patients) told us, “I have no complaints about this place at all,” “I am always treated with dignity and respect” and “the staff are always very friendly”.

Members of staff told us that they liked working at the practice and have monthly team meetings. Staff also commented on the training they had received saying, “I have completed my NVQ level 2 and 3” and “I have done dignity and respect training and equality and diversity training on line”.