We carried out an announced comprehensive inspection on 12 January 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Blue Sky dental service is located on the outskirts of Darwen and provides an NHS and private dental service to people of all ages. The premises is a three story terraced house on a busy road. Car parking is available on the road outside the practice and on nearby streets. A ramp to the front door provides access for wheelchairs. Three are three surgeries; two on ground floor and one on the first floor. Access to one of the ground floor surgeries has been modified for wheelchair access. Both ground floor surgeries have radiography facilities. The practice has a fully equipped decontamination room.

Three dentists, a dental hygienist/therapist and five dental nurses work at the practice. The practice is open Monday from 9.00am to 7.30pm and Tuesday to Friday from 8.00am 5.45pm.

The practice owner is registered with the Care Quality Commission (CQC) as an individual. Like practice owners, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We reviewed 24 CQC comment cards on the day of our visit and spoke with three patients during the inspection. Patients were extremely positive about the staff and standard of care provided by the practice. Patients commented that they felt involved in all aspects of their care and found the staff to be helpful, respectful, and friendly, and said they were treated in a clean and tidy environment.

Our key findings were:

• The practice had effective governance and quality assurance processes in place.
• The practice was well organised, visibly clean and free from clutter.
• An infection prevention and control policy was in place. Sterilisation procedures followed Department of Health guidance.
• The practice had systems for recording incidents and accidents.
• The practice had a safeguarding policy and staff were aware on how to escalate safeguarding issues for children and adults should the need arise.
• Staff received annual medical emergency training. Equipment for dealing with medical emergencies reflected guidance from the resuscitation council (UK).
• Dental professionals provided treatment in accordance with current professional guidelines.
• Patient feedback was regularly sought and reflected upon.
• Patients could access urgent care when required.
• Dental professionals were maintaining their continued professional development (CPD) in accordance with their professional registration.
• Complaints were dealt with in an efficient and sensitive manner.
• The practice was actively involved in promoting oral health.
• Recruitment checks had not been completed for all staff.
• Not all products that could be hazardous to health had been risk assessed and stored securely.
• Water temperature checks on taps were not being carried out as frequently as they should.
• Routine checks of fire equipment and systems to minimise the risk of fire were not in place.

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

• Review the current Legionella risk assessment, including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05:
• Review the practice’s waste handling policy and procedure to ensure waste is segregated and disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Review responsibilities regarding to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date, and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested and recorded suitably.
• Review the arrangements for fire safety to ensure regular checks of fire safety systems take place.

People described the service as excellent.

People said that treatments were explained to them and where applicable they were involved in any decisions.

People said they were thoroughly examined and had a plan developed with them to continue their care needs.

People said the surgery and equipment was very clean.

People said they and staff wore protective equipment to help prevent the spread of infection.

There was sufficient information about care and costing's for people to make an informed choice of treatment.

All the patients spoken to on the day of the site visit said they were happy with their care and treatment.