We carried out this unannounced inspection on 13 November 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

Inspire Dental Centre is in Heath Hayes and provides NHS and private treatment to adults and children.

The reception area is located on the ground floor but all dental treatment rooms and the patient toilet are on the first floor of this practice and can only be accessed by stairs. There is a free car park within a short walk of the practice and parking on local side roads is also available near the practice.

The dental team includes three dentists, including a foundation dentist. (Dental Foundation Training is a national mandatory training program for newly qualified dentists working as dental general practitioners within the NHS sector). There are also four dental nurses including a trainee dental nurse. Three of the dental nurses also work as receptionists. 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 Inspire Dental Centre, Heath Hayes was the principal dentist.

During the inspection we spoke with two dentists, three dental nurses, one of which was working on the reception desk. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday and Friday 9am to 5.30pm, Tuesday, Wednesday and Thursday 9am to 6pm. The practice is closed for an hour each lunchtime between the hours of 1pm to 2pm.

Our key findings were:

• The practice appeared clean and well maintained. Patients commented that improvements had been made as a result of refurbishment.
• 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 check of portable electrical appliances was overdue, there was no evidence that visual checks of portable electrical appliances took place. There was no evidence of a five-year fixed wiring test but we were told that this would be arranged.
• There was no evidence of servicing or maintenance of emergency lighting. Following this inspection, the provider obtained a quote regarding this.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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.
• Staff felt involved and supported and worked well as a team. Staff took it in turn to chair the practice meetings.
• The practice asked patients for feedback about the services they provided. Positive feedback was received.
• The practice did not display its complaint policy for patients to see. A sign in the waiting room stated that patients would have to ask at reception for a copy of this policy.
• The practice staff had suitable information governance arrangements. Staff signed a document each year to confirm that they had read the practice’s policies.

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

• Review the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

• Review the practice’s system for investigating and reviewing accidents, incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review the practice's complaint handling procedures and establish an accessible system for identifying, receiving, recording, handling and responding to complaints by service users.