We carried out this announced inspection on 28 January 2019 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

Honley Dental Practice is in Holmfirth and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes four dentists, six dental nurses, a dental hygienist, a dental hygienist / therapist and a practice manager. The practice has four 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 Honley Dental Practice is the principal dentist.

On the day of inspection, we collected seven CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists, three dental nurses, one dental hygienist 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 Thursday from 8:30am to 5:30pm

Friday from 8:30am to 12:30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Some medical emergency equipment had passed its expiry date.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures. There were no hepatitis B titre levels for one member of staff and no risk assessment to mitigate its absence.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices. In particular the transport of sterilised instruments back to the surgeries.
• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.
• Review stocks of equipment for dealing with a medical emergencies and the practice's system for identifying out-of-date stock.
• Review the practice’s protocols to ensure audits of infection prevention and control are undertaken at six monthly intervals as recommended in nationally recognised guidance.

During our inspection of this service we were able to talk with four people who used the service who told us that they were satisfied with the service provided.

People's comments about the practice included:

"I'm really pleased with the practice and think it's brilliant."

"Staff are really helpful and friendly."

We found that the service followed best practice in gaining people's consent to treatment, providing choices, delivery of treatment and hygiene standards. Staff told us that they received good training and enjoyed working at the practice.

Staff we spoke with told us that they enjoyed working at the practice and felt supported by the registered manager and the Practice Manager.

We saw that the practice was also a member of the British Dental association's (BDA) good practice scheme.