We carried out this announced inspection on 28 August 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

Sandygate Dental Practice is in Sheffield and provides NHS and private treatment to adults and children.

There is level access into the practice which leads to the reception and waiting area. The treatment rooms are located on the first and second floor, patients with mobility requirements are referred to a local practice that can help with access more easily. Car parking, including spaces for blue badge holders, are available near the practice.

The dental team includes two dentists, six dental nurses (two of whom are trainee dental nurses and one is a lead dental nurse). The team is supported by a dental hygiene therapist, a reception manager and a practice manager. 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 34 CQC comment cards filled in by patients and spoke with four other patients.

During the inspection we spoke with the principal dentist, two dental nurses, the reception manager 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 8:30am to 6pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance; improvements could be made to enhance staff awareness of guidance and embed processes.
• 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 practice staff had suitable safeguarding processes. Improvements could be made to enhance awareness of staff 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.
• The provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice 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 staff awareness of safeguarding responsibilities and training requirements to ensure staff know about the signs and symptoms of abuse and neglect and how to report concerns.
• Review staff awareness of Gillick competency and the requirements of the Mental Capacity Act 2005 to ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the practice’s infection control procedures and protocols 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: embed processes in line with guidance

People told us that staff explained all the procedures and treatments to them and respected their decisions about their treatment and care. One person said "The dentist explains everything, I am very impressed with them.”

People who used the service told us they were happy with the care and treatment they received at the practice. One person said “Reception staff are remarkably friendly.”

We asked three people if they felt safe at the service. Everyone said "Yes" and one person added "I’ve not felt worried."

We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection. People we spoke with told us the unit was always clean and tidy.

The provider had an appropriate system in place for gathering, recording and evaluating information about the quality and safety of care the service provides. People who used the service and their representatives were asked for their views about their care and treatment.