We carried out this announced inspection on 27 November 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. They did not provide any information of concern.

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

DCO Dental Group - Timperley is in Altrincham and provides NHS and private treatment to adults and children. The practice is located within a GP surgery.

There is level access for people who use wheelchairs and pushchairs. The practice has a car park with dedicated spaces for patients with disabled badges.

The dental team includes five dentists (one of whom is a foundation dentist), six dental nurses, one dental hygiene therapist, one receptionist and a practice manager. The practice has three treatment rooms. DCO Dental Group - Timperley is a foundation training practice. Dental foundation training is a post-qualification training period, mainly in general dental practice, which UK graduates need to undertake in order to work in NHS practice.

The practice is owned by a partnership 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 DCO Dental Group - Timperley was one the partners.

On the day of inspection we collected 23 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with four dentists, 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, Wednesday and Thursday from 8:00am to 8:00pm

Tuesday from 8:00am to 6:00pm

Friday from 8:00am to 4:30pm

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.
• 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.
• 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.

We identified areas of notable practice through visible leadership within the practice. For example:

• The practice had trained the GPs in the building about the signs and symptoms of oral cancer. They also offered an open door arrangement with the GPs if they ever had concerns about a suspicious lesion in a patient’s mouth.
• The practice was involved in organising a weekly event called “Brew and brush”. This was an opportunity for older patients to get together and do activities such as painting to help combat loneliness and isolation.

Three patients using this service told us that staff treated them in a respectful manner. They said that they had been given sufficient information to make informed choices about their treatment options. Patients described dental staff as friendly, helpful and respectful and one patient described the service as, "Value for money."

The patients we spoke with confirmed that they were always asked if there had been any changes in their health status and the medication they had been prescribed since their last appointment. We also found that allergies had been highlighted in patient records. One patient told us that their allergy to penicillin had been recorded in their notes.

Appropriate policies and procedures had been implemented to make sure that vulnerable adults and children were safeguarded from abuse. Dental staff had been trained in the action they must take if they suspected a patient might be at risk of abuse.

The dental staff we spoke with told us that they worked well as a team. They said that they received good support from the management with their continuing professional development. One member of staff commented, "Everyone has been very supportive. Everyone's views count and we have good working relationships."

We saw evidence that this dental practice had implemented a robust system of quality assurance to make sure that the service was continually improved in the best interests of their patients.