We carried out this announced inspection on 26 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

Grange Road West Dental Practice is in Jarrow and provides NHS and private treatment to adults and children.

The practice entrance has a single step in front; a portable ramp is available for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes two principal dentists, five associate dentists, two foundation dentists, the practice manager, eight dental nurses (including one trainee dental nurse), two dental therapists and a receptionist. The practice has five treatment rooms.

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 Grange Road West Dental Practice is one of the principal dentists.

On the day of inspection, we collected 11 CQC comment cards filled in by patients. These provided a positive view of the practice.

During the inspection we spoke with four dentists, the practice manager and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 9am to 7.30pm

Tuesday to Friday – 9am to 5.pm.

Our key findings were:

• The practice appeared 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 risks. Recommended actions from the practice’s Legionella and fire risk assessments had not been completed.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures. The processes for undertaking Disclosure and Barring Service (DBS) checks and for obtaining evidence of qualifications of staff required reviewing.
• 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 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 dealt with complaints positively and efficiently.
• The practice was involved in training programmes for dental nurses and newly qualified dentists.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review the practice’s risk management systems to ensure all recommended actions identified by risk assessments are completed.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.

We spoke with patients about the treatment and care they received. They told us they were happy with the practice and were very complimentary of the care they received. One person told us, “You couldn’t have chosen a better practice to inspect. They are simply wonderful, excellent at their work and caring”. Another patient told us, “Since the new dentists took over, they have enhanced the already good service to an excellent service. They have bought new equipment and the place is clean and welcoming”.

Patients we spoke with told us they had the opportunity to ask questions about their treatment and to seek reassurances from their dentist before they signed the treatment consent form. One patient told us, “You never get treatment without a full explanation of the treatment and how much it would cost”. Another patient told us, “Everything is above board and you know what you are getting”.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. Patients we spoke with told us they had the opportunity to ask questions about their treatment and to seek reassurances from their dentists before they signed the treatment consent form.