We carried out this announced inspection on 21 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

Parkview Dental Practice is in Huddersfield and provides NHS and private treatment to adults and children.

The practice has a portable ramp to facilitate access to the practice for wheelchair users to the basement. Car parking is available near the practice.

The dental team includes 12 dentists, 15 dental nurses (four of whom are trainees), an infection control co-ordinator, two dental hygienists, three receptionists, a practice manager and a financial manager. The practice has nine 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. At the time of inspection there was no registered manager in post as required as a condition of registration. A registered manager is legally responsible for the delivery of services for which the practice is registered.

On the day of inspection, we collected 32 CQC comment cards filled in by patients.

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

The practice is open:

Monday to Friday from 9:00am to 5:00pm

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. On the day of inspection not all medical emergency equipment was available. These were ordered immediately, and evidence sent to confirm receipt.
• 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 procedures. Improvements could be made to the process for obtaining Disclosure and Barring Service checks at the point of employment.
• 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.
• The provider had suitable information governance arrangements.

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

• Review the process for ensuring equipment is maintained according to nationally recognised guidance.
• Review the fire risk assessment and ensure sources of emergency lighting are available on the top floor of the premises.
• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
• Review the providers registration conditions to ensure the regulated activities at Parkview Dental Practice are managed by an individual who is registered as a manager.

We spoke with three people while they were waiting to see a dentist. They all told us they were happy with the service provided. They told us the dentist always provided an explanation of proposed treatment and gave them information to make an informed choice. This was evidenced in the dental records we looked at.

We saw the dentist made a record of any advice given and proposed treatment. We saw they provided written treatment plans and if tooth/teeth extraction was required, they also provided a pictorial plan of the tooth/teeth they proposed to take out. The principle dentist told us they did this to ensure people were fully informed and understood the treatment proposed.

We looked around the premises and saw dental equipment including emergency equipment was available and appropriately maintained.

We looked at two sets of recruitment records and saw the practice had appropriate procedures in place for the recruitment of new staff. We spoke to a new member of staff who told us they had received training for their role.

We did not talk to any people who use the service as part of this inspection.

We did not talk to any patients as part of this inspection.