We carried out this announced inspection on 29 January 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

The Dental Treatment Centre is in Flixton, Manchester and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. A large car park is available directly opposite the practice, including spaces for blue badge holders.

The dental team includes the principal dentist, three dental nurses (one of whom is the practice manager), a dental hygiene therapist and one receptionist. The practice has one treatment room.

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 30 CQC comment cards filled in by patients. They were highly positive about staff and the service provided.

During the inspection we spoke with the dentist, a dental nurse, the dental hygiene therapist 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 and Wednesday 9am to 1pm

Tuesday 9am to 8pm

Thursday 9am to 6pm

Friday 9am to 5pm

Our key findings were:

• The premises were 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 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.
• 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 had systems to deal 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 the requirements of the Mental Capacity Act 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

• Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Review the practice’s protocols to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.

We visited The Dental Treatment Centre on 9 January 2014. The building was accessible to people with mobility difficulties and there was a free car park opposite the premises.

All areas were clean and tidy and there was clear signage. The practice produced a patient leaflet and other information offering advice and information about the service was available in the waiting room.

Emergency medical equipment was in place and staff undertook annual training in cardiopulmonary resuscitation (CPR). Decontamination processes were followed and hygiene procedures adhered to, minimising the risk of cross infection.

We looked at a sample of electronic records, which contained up to date medical information. Patients were provided with explanations of their treatment options and given time to make an informed decision.

Staff had access to continual training and development. We spoke with one member of staff who felt they were well supported in their employment.

We spoke with three patients who were all positive about the care and treatment they received at the practice. One patient told us, "The staff are some of the best I’ve dealt with”, another said, “The general level of care is excellent. Treatment is explained carefully and thoughtfully”.

There was a complaints procedure, summarised in the patient leaflet. Patient feedback was sought and results used to inform improvements to the service. Audits were regularly undertaken and issues addressed as necessary.