We carried out this announced inspection on 09 August 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

Dentique Dental Practice is located in Leicester and provides private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the practice’s car park.

The dental team includes three dentists, seven dental nurses (including two trainees), one dental therapist, one decontamination assistant (who also works as the practice cleaner), one receptionist, an assistant practice manager and a practice manager (who also works as a treatment co-ordinator).

The practice provides general dental treatment, dental implants and orthodontics.

The practice has four treatment rooms, two are on the ground floor.

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 Dentique Dental Practice is the practice owner.

On the day of inspection, we collected 46 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, the practice owner, the dental therapist, the decontamination assistant, the assistant practice manager and the practice manager.

We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday, Tuesday, Wednesday and Thursday from 8am to 6pm, Friday from 8am to 5pm and Saturday from 8am to 12pm once a month.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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. We noted some areas of risk that had not been identified expeditiously.
• The practice staff had mostly suitable safeguarding processes. Staff demonstrated awareness of their responsibilities for safeguarding adults and children. We found that some staff had not updated their safeguarding training within the last three years. This was updated following our inspection.
• The practice had staff recruitment procedures; we found that some of these required strengthening.
• The clinical staff provided patients’ general dental care and treatment in line with current guidelines.
• The practice provided oral sedation to those patients who would benefit. Whilst the practice had most systems in place to administer this safely, we identified areas that required review. The provider told us they would review guidance and made a decision to stop providing sedation until their review was completed.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice staff were not aware of interpreter services.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, ensuring that risks are identified promptly and assessments completed expeditiously.
• Review the practice’s protocols for conscious sedation, taking into account the guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.
• Review the availability of an interpreter service for patients who do not speak English as their first language.