We carried out this announced inspection on 30 May 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

Harborough Dental Care is in Northampton and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including for patients, are available near the practice.

The dental team includes three dentists, three dental nurses, one trainee dental nurse and one receptionist. The practice has three treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected three CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open: Monday to Friday from 7.45 am to 5.30 pm.

Our key findings were:

• The practice was clean and mostly well maintained.
• The practice had infection control procedures which reflected published guidance, with the exception of a test for the effectiveness of the steam penetration of the vacuum autoclaves. This test was implemented following the inspection.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had limited systems to help them manage risk. Evidence was sent following the inspection of improvements in this regard.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place.
• 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 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.

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

• Review the practice's environmental risk assessments and ensure a fire risk assessment is undertaken and the necessary actions implemented.
• Review the practice's current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.

• Review the practice’s testing protocols for equipment used for cleaning used dental instruments taking into account guidelines issued by the Department of Health - 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.

We spoke with one patient at the practice and they told us that they were happy with their dentist and staff at the practice. They told us that they liked the staff as they were friendly and that they felt their dentist explained treatment to them extremely well and that they were able to make decisions about their own treatment. They also told us that they had never had any problems with the treatment they had received at the practice and that the dentist took every precaution to ensure their safety.

We observed two patient's appointments and found that the dentist examined the healthiness of their teeth and gums. The dentist explained what they were doing at each stage and of the examination and what they were looking for.