We carried out this announced inspection on 20 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.

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

Green Square Dental Limited is in Rotherham and provides private treatment to adults and children, which includes dental implants, intravenous sedation, restorative and cosmetic dentistry.

There is ramp access for people who use wheelchairs and pushchairs. Car parking spaces, including one space for patients with disabled badges, are available at the practice.

The dental team includes the principal dentist, a practice manager, three dental nurses (one of which is a trainee) and a dental hygienist.

The practice has two surgeries; a dedicated room for taking cone beam computed tomography (CBCT) scans, a decontamination room for sterilising dental instruments, a staff room/kitchen and a general office.

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 Green Square Dental Limited was the principal dentist.

On the day of inspection we collected 20 CQC comment cards filled in by patients and spoke with one patient. This information gave us a very positive view of the practice.

During the inspection we spoke with the principal dentist, one dental nurse 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 9am - 7:30pm, Tuesday 12:30pm - 7:30pm, Wednesday 9am – 5:30pm.

Thursday 9am – 5pm, Friday and Saturday 8:30am – 13:30pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance. We identified some areas where improvements could be made.
• Staff knew how to deal with emergencies. Appropriate medicines were available; some life-saving equipment was not present.
• The practice had systems to help them manage risk. A comprehensive Legionella risk assessment was required.
• 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.
• We identified an area for improvement in relation to the use of Cone Beam CT (Computed Tomography) equipment.
• 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 an areas of notable practice:

• The practice was engaged with the local community and The Department for Work and Pensions (DWP) to offer temporary work placements for disadvantaged individuals and those with physical impairment who were finding it difficult to get into work or get a work experience.

  For example, an individual with dyslexia came to work at the practice over a four week placement with a coach who assisted them during the placement. They worked in the waiting room keeping it tidy and clean.

• The practice also worked in association with a local children’s hospice offering emergency dental appointments to the families who were staying with their ill child at the hospice.

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

• Review the practice procedures and take into account HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam CT (Computed Tomography) Equipment in having quality assurance measures for the use of the Cone Beam Computed Tomography scanner (CBCT). Produce a policy to support its use and include CBCT into local rules for radiography.