We carried out this announced inspection on 14 February 2019 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

Brinnington Dental Practice is co-located within Brinnington Health Centre in Stockport, Cheshire and provides predominantly NHS and treatment to adults and children. Some private treatment is available.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including X for blue badge holders, are available outside the practice.

The dental team includes one dentist, one dental nurse, and one receptionist. The practice has one treatment room.

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 21 CQC comment cards filled in by patients and spoke with one patient.

During the inspection we spoke with the dentist, the dental nurse, and receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open on Monday and Tuesday from 9.30am to 12pm, on Wednesday and Thursday from 9.30am to 5pm, and on Friday from 9.30am to 4pm.

Our key findings were:

• The practice was clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Some items were missing from the emergency kit or had just gone out of date.
• The practice had systems to help them manage risk to patients and staff. A dental dam was not always used, in line with recognised guidance, and other safety methods used were not routinely recorded in patients dental care records.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Overall, record keeping was of a good standard. Improvements could be made to the process to record dental examinations and assessments.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

There were areas where the provider could make improvements. The provider could:

• Review the practice’s protocols for the use of a dental dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the practice's protocols for completion of dental care records taking into account the guidance provided by the Faculty of General Dental Practice.