We carried out this announced inspection on 05 June 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

Banksdental is in Marske-by-the-Sea and provides private treatment to adults and children.

There are two small steps in front of the practice. The practice is planning to purchase a portable ramp for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes the principal dentist and two dental nurses who also work as receptionists. The practice has two treatment rooms. The ground floor treatment room was purpose-built recently to accommodate those who find difficulty ascending the stairs. The principal dentist also had a ground floor patient toilet installed and is currently implementing other changes to this. For example, a hand rail and call bell will be installed to provide support.

The practice is owned by an individual who is the principal dentist there. 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 31 CQC comment cards filled in by patients.

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

The practice is open:

Monday, Wednesday and Friday 9am to 5pm.

Our key findings were:

• The practice appeared 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 - apart from two items.
• The practice had some systems to help them manage risks. The practice had not undertaken suitable risk assessments for Legionella or hazardous substances held on-site.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures. These procedures required reviewing.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• 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.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.
• The practice was providing preventive care and supporting patients to ensure better oral health in line with current guidelines.

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

• Review the practice's recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff. The principal dentist should consider implementing a recruitment policy.
• Review the practice's policy for hazardous substances identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• Review the need for a competent person to undertake a Legionella risk assessment of the premises 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’.

On the day of the visit the provider had cancelled all appointments so we were unable to talk to patients From the questionnaires we looked at people said that they were happy with the service provided. They felt their dignity was maintained and their privacy protected.