We carried out an announced comprehensive inspection on 3 November 2016 to ask the practice the following key questions; are services safe, effective, caring, responsive and well-led?

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

Harbour Dental Practice is located in the centre of Sandbach and comprises a reception and waiting room and four treatment rooms on the ground floor, and a further waiting room and two treatment rooms on the first floor. Parking is available on nearby streets. The practice is accessible to patients with disabilities, impaired mobility, and to wheelchair users.

The practice provides general dental treatment to patients on an NHS or privately funded basis. The opening times are Monday to Friday 9.00am to 5.30pm and Saturday 9.00am to 12.30pm. The practice is staffed by seven dentists, a practice manager, one dental hygienist, and eleven dental nurses, two of whom are trainees.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We received feedback from seven people during the inspection about the services provided. Patients commented that staff were helpful, friendly, and caring. They said that they were always given good explanations about dental treatment, and that the dentists listened to them and treated them as individfuals. Patients commented that the practice was clean and comfortable.

Our key findings were:

• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies, and emergency medicines and equipment were available.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the running of the practice.
• The premises and equipment were clean and secure but some areas of the practice showed signs of wear and deterioration.
• Staff followed current infection control guidelines for decontaminating and sterilising equipment, but sterilised instruments were not consistently stored in line with current guidance.
• There was evidence of deterioration in the decontamination room fixtures and fittings which did not support good infection control.

There were areas where the provider could make improvements and should:

• Review the practice’s infection control procedures and protocols having due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance, in relation to the general maintenance and security of the decontamination room and the storage of sterilised instruments.
• Review the practice’s waste handling procedures to ensure waste awaiting collection is stored securely in accordance with relevant regulations having due regard to guidance issued in the Health Technical Memorandum 07-01.
• Review the practice’s protocols for conscious sedation, having due regard to the guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015, in relation to undertaking sedation audits and interim medical emergency and life support scenarios.
• Review the complaint handling procedures to ensure opportunities for learning from complaints are fully explored.
• Review its responsibilities to ensure a Disability Discrimination Act audit is undertaken for the premises.