We carried out this announced inspection on 9 January 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 of concern.

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

Hislop and Wolverson dental practice is in Doncaster and provide NHS and private treatment to adults and children. The practice also provides orthodontics and a denture repair service.

There is step access into the practice; ramp access is not possible due to the gradient of the path leading up to the practice. People who use wheelchairs and pushchairs are assisted into the practice by staff members or supported to find an alternative practice. Car parking spaces are available near the practice.

The dental team includes five dentists, nine dental nurses (three of which are trainees) and a receptionist. The practice has five treatment rooms, an instrument decontamination room. There are two rooms on the ground floor which are used as a dental laboratory; the dental laboratory operates independently from the practice and is run by a self-employed dental technician.

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 Hislop and Wolverson was the senior partner.

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

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

The practice is open:

Monday to Friday 9am – 5:30pm

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. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk. Improvements could be made in respect to fire safety, Control of Substances Hazardous to Health (COSHH) and waste management.
• 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 practice's environmental risk assessments paying attention to the rooms used by the dental technician to ensure a comprehensive fire risk assessment is undertaken and the necessary actions implemented.
• Review the practice's waste handling protocols to ensure X-ray chemicals and gypsum waste is segregated and disposed of in accordance with relevant regulations taking into account guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Review the security of in-use prescription pads in the practice.
• Review the analysis of the grades for the quality of radiographs to ensure these are correctly recorded over each audit cycle and for each dentist.
• Review the practice’s procedures for closed-circuit television (CCTV) and compliance with the Information Commissioner’s Office protocols (ICO).

We spoke with two people in the waiting room within the practice. They spoke positively about the care and treatment they had received. They told us they were provided with sufficient information for them to make a decision about their treatment. One person told us: "My treatment is always discussed with me." Another person told us: "Staff here are great communication between us is always good." We found people experienced care, treatment and support that met their needs and protected their rights.

We found the practice had systems in place to deal with foreseeable emergencies. Staff had received training in basic life support skills and cardiopulmonary resuscitation.

The practice had systems in place to ensure people who used the service were protected from the risk of abuse.

We looked at infection prevention and control. Evidence showed people were protected from the risk of infection because appropriate guidance had been followed. People we spoke with told us the practice was very clean and tidy and staff always wore protective clothing when treating patients.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. There were regular patient surveys. Feedback and action was taken were necessary.