We spoke with four people who used the service. They told us they were asked for consent prior to any treatment being carried out and were asked to sign a consent form regarding any treatment that was given. Comments from them included: “I have followed my dentist here from another practice. He is great” and “I have been coming here for many years. They are very good.”

We looked at four patient’s records which contained clinical notes detailing examination and treatment planning. It was evident that people who used the service were involved in making decisions about their treatment. We saw the relevant forms were completed in relation to the cost of treatment with patient’s signatures evident to reflect they agreed to the treatment that was provided.

We examined continuous professional development (CPD) for all staff who worked at the practice. We found they were all up-to-date in their training in relation to the safeguarding of vulnerable adults, child protection and deprivation of liberty safeguards (DOLS).

We saw that there was a decontamination room which was used for cleaning dental instruments. The decontamination room contained all the necessary equipment for cleaning and sterilising instruments. We found that a dental nurse was assigned to work here throughout their shift. This ensured that the decontamination processes were consistently followed.

We carried out this announced inspection on 27 February 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.

We told the NHS England Cheshire and Merseyside area team that we were inspecting the practice. We did not receive any information of concern from them.

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

Vicar’s Cross Dental Practice is located in a residential suburb of Chester and provides dental care and treatment to adults and children on an NHS and privately funded basis. The practice also provides dental treatment under sedation on a private basis.

The provider has installed a ramp to facilitate access to the practice for wheelchair users and for pushchairs. The practice has seven treatment rooms. Car parking is available at the practice and bike stands are also available.

The dental team includes a principal dentist, seven associate dentists, three dental hygiene therapists, one dental hygienist, 11 dental nurses, two of whom are trainees, two of whom are also oral health educators, and one of whom is also a treatment co-ordinator, a decontamination technician and five receptionists. The team is supported by a practice manager.

The practice is owned by a partnership and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Vicar’s Cross Dental Practice is the principal dentist.

We received feedback from 14 people during the inspection about the services provided. The feedback provided was positive about the practice.

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

The practice is open:

Monday, Tuesday and Thursday 8.30am to 6.00pm

Wednesday 8.30am to 7.30pm

Friday 8.30am to 5.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had systems in place to help them manage risk. We found some of these could be improved.

There were areas where the provider could make improvements and should:

• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities, specifically in relation to the recording of water temperatures in relation to Legionella risk, the risk to staff working in a clinical environment where their response to the Hepatitis B vaccination is ineffective/unknown, and the recording of accidents including action taken.
• Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are fully informed as to its purpose and their right to access footage.