We carried out this announced inspection on 9 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information which we took into account.

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

Heylings Dental Surgery is in Hull and provides NHS and private treatment to adults and children.

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

The dental team includes two dentists, four dental nurses, a dental hygienist and a receptionist. The practice has three 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 Heylings Dental Surgery was the principal dentist.

On the day of inspection we collected 30 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday – Thursday 8.30am – 5pm

Friday 8.30am – 3pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies.
• The practice had systems to help them manage risk; improvements could be made to the fire risk assessment.
• 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.
• 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 immunisation status of all staff.
• Review availability of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK) and the General Dental Council (GDC) standards for the dental team.
• Review the practice audit protocols to check all audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practice fire risk assessment and equipment testing requirements.

People who used the service told us the dentist, “Are very good and they always explain what is happening during my procedure” People also told us they felt, “Happy with the staff" and "They are always polite.” People were treated with courtesy to ensure their wishes and feelings were respected.

Periodic checks were in place to ensure there was sufficient stock should an emergency arise.

We saw that visual checks had taken place to ensure that drug quantities were sufficient and the expiry date had not passed.

We observed staff wearing personal protective equipment and they confirmed these were always available. We spoke with people who used the service who confirmed staff always used personal protective equipment during treatment.

We saw evidence that a range of staff training was provided which ensured they were able to carry out their roles and kept their professional skills up to date.

We found the provider carried out checks of both clinical and non clinical areas and had a quality programme in place that ensured any improvements can be captured, reported and acted on.