We carried out this announced inspection on 13 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 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

Street Lane Dental Centre is in Moortown on the outskirts of Leeds and is an approved training (for foundation dentists) practice that provides private and NHS dental care to adults and children.

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

The dental team includes eight dentists (one of whom is a foundation dentist), two dental hygienists, eight dental nurses, a practice manager and a receptionist. The practice has six 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 Street Lane Dental Centre was the practice manager.

On the day of inspection, we collected 23 CQC comment cards filled in by patients. All feedback received was highly positive.

During the inspection we spoke with three dentists, two 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 to Thursday 8.30am to 5pm and Friday 8.30 to 4pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice 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 good systems to help them manage risk with the exception of fire safety, not all the recommendations had been followed for the fire risk assessments.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement,
• Staff felt involved and supported and worked well as a team, had regular staff meetings, we noted that staff appraisals had lapsed.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with any complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective.
• Review the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.

During the inspection we spoke with patients who told us they had been coming to the dental practice for many years. Patients told us they were fully involved in the decisions about their dental care and treatment. They said the dentist always discussed treatment options and cost with them to help them make an informed decision.

We spoke with five patients who told us they were very satisfied with their experience of using the service. They said the staff were caring and easy to talk with. Comments made included, “I had a fear of dentist but I am now confident because they are fantastic.” “Excellent service they are very professional.” Patients told us they did not have to wait long for an appointment with the dentist.

Patients said the dentists explained the consultation procedure, which treatment would be most effective and reasons why they thought so. Patients felt they were treated with dignity and respect and said they had received consultations and treatment in private.

We saw treatment plans were detailed and included different options where these were appropriate and enabling patients to make an informed choice.

Staff told us they were well supported in their work and they enjoyed working in the practice. They told us communication was excellent and they were all able to contribute to how the service was provided.

We saw arrangements in place to deal with emergency situations including training for staff in medical emergencies and resuscitation.

The practice had effective procedures in place for the management of infection control. There was evidence to show that staff had received training to reduce the risk of infection.

We saw complaints were dealt with appropriately by the practice in line with their own procedures.

The practice was clean and tidy. Personal protection equipment such as aprons, gloves and eye protection was used appropriately. The patients we spoke with said the practice was always clean and tidy.