We carried out this announced inspection on 2 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 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

Highfields Dental Practice is in the Highfields area of Leicester close to the city centre and provides mostly NHS dental treatment to adults and children.

There is level access into the practice, this is of benefit for people who use wheelchairs and those with pushchairs. There is roadside parking in the area around the practice.

The dental team includes six dentists, four qualified dental nurses, one trainee dental nurse and one practice manager. The practice has three treatment rooms, two of which are located on the ground floor.

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 the time of the inspection was the practice manager.

On the day of inspection, we received feedback from 43 patients.

During the inspection we spoke with three dentists, two dental nurses 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 to Friday: 9am to 4:30pm, other times are by appointment only. The practice is closed on Saturday and Sunday.

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Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice staff 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.

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

• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We spoke with two dentists about how they obtained the consent of people who used the service. We were told about the process of describing treatment options that were available to people and how to present this in a way the person understood.

We spoke with two people who had received treatment at the time of our visit. We asked them about the care and treatment they had received. Comments included: - “it’s a good practice, they’re always making changes to improve”, “they’ve always discussed things first and explained what would happen” and “it’s nice, they’re all friendly and polite”.

There were effective systems in place to reduce the risk and spread of infection. We reviewed the infection prevention and decontamination policies and found them to be up to date and comprehensive with responsibilities clearly defined.

We found there were effective recruitment and selection processes in place and the provider had an effective quality assurance system to monitor the quality of service provided.