We carried out this announced inspection on 12 April 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

Honesty Dental Care is in Baildon and provides private treatment to adults and children. Treatments include dental implants, orthodontics and treatment under conscious sedation.

There is level access for people who use wheelchairs and those with pushchairs. The practice has a dedicated car park with one space for blue badge holders.

The dental team includes five dentists, seven dental nurses (one of whom is a trainee), two dental hygiene therapists, a patient liaison co-ordinator, a receptionist and a practice manager. The practice has three 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 Honesty Dental Care was the principal dentist.

On the day of inspection, we collected 44 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, four dental nurses, the receptionist 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 and Wednesday from 8:00am to 8:00pm

Tuesday, Thursday and Friday from 8:00am to 6:00pm

Saturday from 9:00am to 2:00pm

Our key findings were:

• The practice appeared 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 to the process for reducing the risks associated with Legionella and fire.
• 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 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.
• The practice asked staff and patients for feedback about the services they provided.
• Improvements could be made to the process for recording complaints by service users.
• The practice had suitable information governance arrangements.

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

• Review the current Legionella risk assessment and implement the required control measures including the monitoring and recording of water temperatures.
• Review the fire safety risk assessment and ensure checks of the emergency lighting and firefighting equipment are carried out at regular intervals.
• Review the practice's complaint handling procedures and establish an effective system for recording complaints by service users.

During the inspection day we had the opportunity to speak with one person who used the service. They told us they were highly satisfied with the care and treatment provided.

Their comments included: "The dentist talked to me and made me feel at ease, he is fantastic", “I got an emergency appointment very quickly for my husband out of hours, the dentist came in especially for us, We are in safe hands here” and “the place is modern and spotless.”

We found the provider had appropriate systems in place to ensure consent was gained before they proceeded with the examination or treatment.

We found the provider had taken steps which ensured the care and welfare of people who used the service. There were arrangements in place to deal with medical emergencies.

We found the provider operated in clean and tidy facilities and had suitable infection prevention and control protocols in place.

We saw evidence there was an appropriate system in place for listening to and acting on people’s comments and concerns.