We carried out this announced inspection on 13 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

Crigglestone Dental & Implant Care is situated near Wakefield and provides NHS and private treatment to adults and children.

There is access for people who use wheelchairs and pushchairs. Car parking spaces, including one for patients with disabled badges, are available at the rear of the practice in a dedicated car park.

The dental team includes three dentists, two dental nurses, one dental hygienist therapist, two receptionists and a practice manager. The practice has two 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 Crigglestone Dental & Implant Care was the practice manager.

On the day of inspection we received feedback from 11 patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, one dental nurse, one receptionist 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 to Friday from 9:00am to 5:20pm

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. One emergency medicine was not being stored in line with manufacturer’s guidance.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures. We identified that Disclosure and Barring Service (DBS) checks were not always practice specific.
• 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 appointment system met patients’ needs.
• The practice had effective leadership. 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 and should:

• Review the storage of medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance.
• Review the local rules for use of X-ray equipment and ensure they reflect the multi-entrance layout of the surgeries.
• Review the storage of dental care records to ensure they are stored securely.
• Review the practice's recruitment policy and procedures to ensure a valid DBS check is available at the point of employment.

We spoke with five people who used the service, one Dentist, and two members of staff. People who used the service were happy with the quality of care and dental treatment offered by the dental practice. Comments included:

“I’ve been coming here for years, I wouldn’t go anywhere else.”

“The staff are always very polite and friendly.”

In the three patient records we looked at, we saw evidence that information about the people who used the service, such as medical history, had been completed in all records.

There were effective systems in place to reduce the risk and spread of infection. During our inspection we asked a member of staff to explain the decontamination process. We saw that there was a room dedicated to carrying out decontamination and that there was a clear dirty to clean route through the room.

We looked at three staff files. These contained a contract of employment, job description, training certificates and Criminal Record Bureau checks.

The provider had systems in place to identify, analyse and review risks and incidents.

Information about quality and safety was gathered and monitored to identify risks and areas for improvement.