We carried out this announced inspection on 14 August 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

Hatfield Dental Care Limited is in Doncaster and provides NHS and private treatment to adults and children.

There is ramp access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes a principal dentist and an associate dentist, six dental nurses (two are trainee dental nurses), two dental hygiene therapists, a practice manager and a receptionist. The practice has three treatment rooms and two decontamination rooms.

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 Hatfield Dental Care Limited was the principal dentist.

On the day of inspection we collected 43 CQC comment cards filled in by patients and spoke with 13 other patients. This information gave us a very positive view of the practice.

During the inspection we spoke with the principal dentist, two dental nurses, one dental hygiene therapist and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Thursday: 8am – 4:30pm

Tuesday: 8am – 7:30pm

Wednesday: 8am – 1:30pm

Friday: 8am – 5pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance; we identified some minor areas which required further consideration.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available but some processes and availability of staff training could be improved.
• The practice had systems to help them manage risk; some associated areas of risk could be improved.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place but these could be improved upon.
• 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 a leadership structure. 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 system for reviewing incidents or significant events with a view to preventing further occurrences and ensuring staff awareness and those improvements are made as a result.
• Review staff training to ensure all staff are trained to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s sharps procedures and ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the storage of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review the practice’s infection control procedures, protocols and audit to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’, ensure staff are aware of who is the lead person in the practice for infection control procedures.
• Review the servicing schedule of the pressure vessel equipment used for providing care or treatment to a service user and ensure they are serviced and maintained in accordance with manufacturer’s instructions.