We carried out this announced inspection on 18 December 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

Glodwick Dental Centre is in Oldham and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces and additional on street parking is available near the practice.

The dental team includes five dentists and two foundation dentists, 12 dental nurses (three of which are trainees), a dental hygiene therapist. The clinical team is supported by a practice manager. The practice has six treatment rooms, three on the ground floor and three on the first 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 Glodwick Dental Centre is one of the principal dentists.

On the day of inspection, we collected 30 CQC comment cards filled in by patients. Patients were positive about all aspects of the service the practice provided.

During the inspection we spoke with four dentists, dental nurses, the dental hygiene therapist 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 & Thursday 08:00 to 12:00 and 13:00 to 17:00

Tuesday & Friday 09:00 to 13:00 and 14:00 to 18:00

Wednesday 08:00 to 13:00 and 14:00 to 18:00

Our key findings were:

• The premises were 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.
• The practice had systems to help them manage risk to patients and staff.
• The practice staff 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.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The provider 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 provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

We identified areas of notable practice:

The registered provider had systems to review the general and oral health profile of the local population and target areas for improvement. Staff understood the needs of the local population, they planned and targeted their services to meet their needs and address inequalities. For example, alcohol-related harm, smoking and the use of betel nut. Patients were provided with oral health kits. The practice were forging close working relationships with other healthcare providers to support them with signposting patients and appropriate prescribing.

There was a proactive support system in place for staff to develop their knowledge and skills, and motivate them to provide a quality service. The team proactively participated in, and piloted projects to remove barriers to accessing dental care and encourage attendance. They forged links in the community with other healthcare providers, schools, nurseries and the local mosque to improve oral health in the locality.

They contributed to a local charity and provided toothbrushes and toothpaste to be included in Christmas welfare packages which were provided to homeless and disadvantaged people.

There was a healthy living champion in the practice who actively supported staff to create bespoke oral health displays. They used skills effectively in the practice to maximise preventative interventions. Bespoke information was created in other languages and for patients during periods of fasting. They recognised the need to remove barriers to care for dementia patients and during periods of fasting for patients. For example, they had adjusted the opening hours to provide a choice of early morning or later appointments. The team ensured that during periods of fasting, Muslim patients could access care and treatment at a time that did not impact on their fast or routine.

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

• Review the practice's Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.’

• Review the practice’s system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.