We carried out this announced inspection on 3 October 2017 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

Warren Drive Dental Practice is located in a residential suburb of Wallasey and provides dental care and treatment to adults and children on an NHS and privately funded basis.

The practice has a portable ramp available to facilitate access to the practice for wheelchair users. The practice has five treatment rooms. Car parking is available outside.

The dental team includes two dentists, a dental hygienist, four dental nurses, one of whom is a trainee, and a patient treatment co-ordinator. The team is supported by a practice manager.

The practice is owned by a company 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. At the time of the inspection the practice did not have a registered manager in post. An application for a registered manager is currently being processed by CQC.

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

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

The practice is open:

Monday to Thursday 9.00am to 5.15pm

Friday 9.00am to 4.15pm.

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.
• 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 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. Most but not all risks had been reduced as far as reasonably practicable.
• The practice had staff recruitment procedures in place. Staff were unclear as to whether checks were carried out for locum staff and whether references were obtained for all staff recruited.
• The practice had a procedure in place for dealing with complaints but sufficient information about this was not available for patients.

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

• Review the practice’s arrangements for recording action taken in relation to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency and through the Central Alerting System as well as from other relevant bodies such as Public Health England, and review the practice’s system for the recording, investigating and reviewing of incidents and significant events with a view to preventing further occurrences and to ensuring that improvements are made.
• Review the protocol for maintaining accurate, complete and detailed records relating to the employment of staff, including locum staff. This includes ensuring recruitment checks, including references, are suitably carried out and recorded.
• Review the practice’s arrangements to ensure an effective system is established to assess, monitor and mitigate the various risks arising from the undertaking of the regulated activities, specifically in relation to the implementation of fire drills, and ensuring that NHS prescription pads in use are locked away securely.
• Review the storage of dental care records to ensure they are all stored securely.
• Review the practice’s complaint handling procedures in relation to providing information to patients about NHS England and the Dental Complaints Service should patients wish to complain to them directly.