We carried out this announced inspection on 26 June 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.

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

Yorkshire Dental Suite is in Leeds and provides private treatment to adults and children. Services include dental implants, conscious sedation and minor oral surgery.

There is level access for people who use wheelchairs and pushchairs. The practice has a dedicated car park which includes one space for disabled badge holders.

The dental team includes five dentists, one dental hygienist and therapist, two dental nurses and a locum dental nurse. The dental nurses also cover reception duties. The practice has two treatment rooms, a recovery room, a decontamination room and an X-ray room.

The practice is owned by an individual who is the principal dentist. 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 46 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday and Friday from 9:00am to 6:00pm

Tuesday and Thursday from 8:00am to 5:30pm

Wednesday from 9:00am to 8:00pm

Saturday – by appointment only

Our key findings were:

• The practice was 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 with the exception of a second oxygen cylinder as the practice provided conscious sedation.
• The practice had systems to help them manage risk. Improvements could be made to the management of fire risks.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures. Improvements could be made to the process for acquiring Disclosure and Barring Service (DBS) checks at the point of employment.
• The practice could improve the process and procedures for the use of the cone beam computed tomography (CBCT) machine.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked patients for feedback about the services they provided.
• The practice had an effective complaints procedure in place.

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

• Review availability of sufficient oxygen giving due regard to guidelines issued by the Standing Dental Advisory Committee: conscious sedation in the provision of dental care “Report of an expert group on sedation for dentistry” (Department of Health 2003).
• Review the current fire risk assessment and implement the required actions including weekly fire alarm tests and bi-annual fire drills.
• Review the protocols and procedures for use of the CBCT scanner / imaging equipment giving due regard to the HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam CT (Computed Tomography) equipment in having quality assurance measures for the use of the Cone Beam Computed Tomography scanner (CBCT).
• Review the practice's recruitment policy and procedures to ensure DBS checks are sought at the point of employment.
• Review the process for documenting consent when using social media.