We carried out this announced inspection on 10 December 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

Nursery Lane dental care is in Alwoodley near Leeds and provides NHS and private treatment to adults and children.

There is access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice and local transport facilities are nearby.

The dental team includes four dentists, four dental nurses (one of whom is a trainee), one dental hygienist, a practice manager and one receptionist. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 50 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two dental nurses, the receptionist 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 to Friday 8:15am-5pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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 staff recruitment processes in place, the recruitment procedure and management of DBS (Disclosure and Barring) checks could be improved.
• 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 complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to all new staff commencing employment at the practice. For example, (Disclosure and Barring) DBS checks.

We spoke with five people who used the service. We also looked at surveys completed by people who use the service and compliments received by the practice.

People who used the service said they were happy with the quality of care and dental treatment offered by the dental practice. People said they were fully involved in decisions about their treatments and felt they got good clear explanations. They also said the practice and surgeries were always ‘spotless’. People’s other comments included:

“Kept fully informed, everything comprehensively explained.”

“Treated spectacularly well.”

“They are great with the kids, a lovely approach, take all the fear away.”

“(name of dentist) put me at my ease.”

“(name of dentist) is a wonderful chap.”

One person who used the service said they sometimes felt a little rushed by the dentist, but they were very happy with the treatment received.

We observed staff treating people with respect, being polite and courteous. We spoke with four members of staff who were all able to explain and give examples of how they would respect people’s dignity, privacy and confidentiality. Records we looked at showed that people who used the service were involved in any decisions regarding their treatment.

There were effective systems in place to make sure equipment was safe; properly maintained, suitable for its purpose and used correctly.