We carried out this announced inspection on 15 April 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

Hanover Dental Practice is in Newcastle Under Lyme and provides mainly NHS with some private treatment to adults and children.

A portable ramp is available to provide access to the rear of the practice for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available in a long stay car park near the practice.

The dental team includes four dentists, six dental nurses (including four trainees), one dental hygienist, three receptionists, a practice manager and a general manager. The practice and general manager are also trained dental nurses. The practice has four 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 Hanover Dental Practice is the senior partner.

On the day of inspection, we received feedback from 24 patients.

During the inspection we spoke with two dentists, two dental nurses, one receptionist, a trainee dental nurse who was working on reception, the practice manager and the general manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 8.30am to 4.30pm. The practice is closed for one-hour lunch each day).

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance. The practice was using a standardised infection control policy. Following this inspection, we were sent a copy of the policy which was amended to reflect the needs of the practice.
• 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 provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures. Not all recruitment information for dentists employed was available on the premises.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked patients for feedback about the services they provided.
• Systems for recording and monitoring complaints could be improved. There was no system in place for monitoring verbal complaints made.
• The provider had suitable information governance arrangements.

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

• 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.

• Introduce protocols regarding the prescribing of antibiotic medicines taking into account the guidance provided by the Faculty of General Dental Practice.
• Review the practice's complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users.

We carried out this inspection to check on the care and welfare of people who used this practice. The inspection was announced, which meant that the provider and the staff knew we were visiting. On the day of our inspection we spoke with six people, five staff and looked at four treatment records. People who received treatment at the practice told us they were very happy with the care that they received. One person told us, “This was my first visit today and they were excellent. Staff were very polite, efficient and helpful”. Another person told us, “The dentist is really nice. He tells me what he is going to do”.

People experienced care, treatment and support that met their needs. This was because people were cared for by suitably qualified, skilled and experienced staff. We saw that the practice was clean and tidy and the premises was a suitable and safe environment for people to receive treatment in. The provider effectively assessed and monitored the quality of service that people received to ensure that it meet their needs.