We carried out this announced inspection on 1 August 2018 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 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

Higher Lane Dental Practice is in the village of Lymm and provides private dental care and treatment for adults and children.

The provider has installed a ramp to facilitate access to the practice for wheelchair users. Car parking is available at the practice.

The dental team includes a principal dentist, three dental nurses and two dental hygiene therapists. The dental team is supported by a practice manager. The practice has two treatment 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 Higher Lane Dental Practice was the principal dentist.

We received feedback from 33 people during the inspection about the services provided. The feedback provided was positive.

During the inspection we spoke to the principal dentist, dental nurses, a dental hygiene therapist, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 8.30am to 5.00pm

Tuesday and Friday 8.30am to 6.00pm

Wednesday 9.00am to 6.00pm

Thursday 9.00am to 5.00pm

Alternate Saturdays 9.30am to 2.30pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place.
• Staff knew how to deal with medical emergencies. The recommended medical emergency medicines and equipment were available.
• The provider had systems in place to manage risk. Action taken to mitigate some aspects of these risks was not sufficient. The provider addressed this after the inspection.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
• The provider had staff recruitment procedures in place. We found that Disclosure and Barring Service checks were not always carried out at an appropriate time.
• Staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their personal information.
• The dental team provided preventive care and supported patients to achieve better oral health.
• The appointment system took account of patients’ needs.
• The provider had a procedure in place for dealing with complaints. Information for patients did not contain sufficient information.
• The practice had a leadership and management structure.
• Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The provider had information governance arrangements in place.

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

• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, in relation to the display of warning and safety signage, completion of the recommended actions in relation to the X-ray equipment, and the disposal of gypsum waste.
• Review the practice's complaint handling procedures and ensure sufficient contact details of alternative organisations for people to complain to are available.
• Review the practice’s systems for assessing, monitoring and improving the quality and safety of the services provided. In particular, review the practice’s protocols for the monitoring of staff training.