We carried out this announced inspection on 25 September 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

The Ropewalk Dental and Implant Suite is located in the centre of Nottingham. The practice is well served by public transport including buses and trams. The practice provides mainly private dental treatment to mostly adults.

The practice is located on the ground floor of a building with level access from the street There is time limited car parking available in the area around the practice.

The dental team includes two dentists, two dental nurses and a receptionist/ office manager. The practice has two 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 principal dentist is the registered manager.

On the day of inspection, we received feedback from six patients.

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

The practice is open: Monday 9am to 5.30pm, Tuesday 9am to 5.30pm, Wednesday 9am to 1pm,

Thursday 9am to 5.30pm and Friday 9am to 1pm. The practice is closed for lunch between 1pm and 2pm. Extra clinics are held once a month Intermediate Minor Oral Surgery: Wednesday 9am to 4pm, Friday 2pm to 7pm and Saturday 8.30am to 2pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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.
• 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 practice did not have all of the medical emergencies equipment identified in the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• 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 decontamination room did not have any natural or artificial ventilation.
• The cleaning schedules completed by the contract cleaner did not adequately ensure the cleanliness of the premises.
• The practice did not have an induction hearing loop to assist patients with hearing loss who used a hearing aid.
• 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 culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.

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

• Review the suitability of the premises and ensure all areas are fit for the purpose for which they are being used. In particular the ventilation of the decontamination room and creating a positive air flow through the room.

• Review the availability of equipment in the practice to manage medical emergencies, taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.

• 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 review the cleaning schedules completed by the contract cleaner.

• Review its responsibilities to the needs of people with a disability, including those with hearing impairments and the requirements of the Equality Act 2010.