We carried out this announced inspection on 28 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

Penwortham Dental Practice is near Preston and provides NHS and private dental care for adults and children.

There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs. Car parking is available near the practice.

The dental team includes seven dentists and eight dental nurses. The dental team is supported by a practice manager. The practice has three treatment rooms.

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 Penwortham Dental Practice was the senior partner.

We received feedback from 45 people during the inspection about the services provided. The feedback provided was positive.

During the inspection we spoke to three 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, Tuesday, Thursday and Friday 8.00am to 5.00pm

Wednesday 8.00am to 7.00pm.

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.
• The provider had staff recruitment procedures in place. References were not consistently obtained.
• Staff took account of some of the current guidance when providing patients’ care and treatment. Some of the recognised guidance was not followed, for example, in relation to the use of dental dam.
• 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.
• 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 for the use of dental dam for root canal treatment taking into account the guidelines issued by the British Endodontic Society.
• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity against vaccine-preventable infectious diseases.
• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice, and that accurate, complete and detailed records are maintained for all staff and stored securely.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere, the reason for taking X-rays, a report on the findings, and on the quality of the image, in 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.