We carried out this announced inspection on 21 July 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

Alan Barnes Dental Care is in the north of Blackpool and provides private dental treatment to adults and children.

The practice is situated on the first floor above a parade of shops. The practice is not accessible for people who use wheelchairs. Arrangements were in place to signpost such people to a nearby dental practice which has easier access. Car parking spaces are available on the roadside near the practice.

The dental team includes three dentists, three dental nurses and one receptionist who is also the practice manager. The practice has four treatment rooms.

The practice is owned by a company 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 registered manager at Alan Barnes Dental Practice was the practice manager.

On the day of inspection we collected 37 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with the principal dentist, two associate dentists, one dental nurse 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, Tuesday and Wednesday: 9.00am – 5.30pm

Thursday: 9.00am – 12.30pm

Friday: 9.00am – 5.00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice did not have infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk but fire safety procedures were not carried out in line with fire safety law.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice did not have thorough staff recruitment procedures.
• Staff training in the practice was not consistent with the General Dental Council’s guidelines and was not monitored effectively by the management team.
• The practice has not been receiving safety alerts and notifications.
• 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 practice did not comply with the safer sharps regulation.
• The appointment system met patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).

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

• Review the practice's fire risk assessment and the necessary actions implemented, for example, fire drills should be undertaken, on at least an annual basis as a minimum, for all staff and the recording all safety checks in an acceptable format.

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

• Review the confidentiality of dental care records to ensure that all electronic records and computers in the practice are password protected.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff

• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development (CPD).

We spoke with a range of people about the service. They included the practice manager,staff, dentists and patients.

Comments we recieved from patients were positive about the way they were treated by staff and about the level of care and treatment they received.

"He is excellent is Alan, he explains everything and he keeps up to date".

" The whole experience is excellent, they will write or telephone before your appointment it is pleasant and the surroundings are brilliant".

"I`ve had four different practises it`s one of the top ones. He takes care and thoroughly checks everything. He is gentle and kind and doesn`t frighten me".

"A nice dentist and all the girls are really helpful".