We carried out this announced inspection on 1 February 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.

We told the NHS England Cheshire and Merseyside area team that we were inspecting the practice. We did not receive any information of concern from them.

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

Johnson & Whitehouse is situated in a residential suburb of Chester and provides dental care and treatment to adults and children on an NHS and privately funded basis.

There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs. The practice has six treatment rooms. Car parking is available near the practice.

The dental team includes seven dentists, seven dental nurses, of whom four are trainees, and two receptionists. The team is supported by a practice manager.

The practice is owned by a partnership and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Johnson & Whitehouse is one of the partners.

We received feedback from 15 people during the inspection about the services provided. The feedback was positive about the practice.

During the inspection we spoke to three dentists, dental nurses, receptionists and the practice manager. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday 9.00am to 6.00pm

Friday 9.00am to 3.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures in place.
• 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 took patients’ differing needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had systems in place to help them manage risk. We observed that not all reasonably practicable measures had been put in place to reduce risks in relation to fire safety, staff immunity to vaccinations, Legionella and used sharps.
• The practice had a procedure in place for dealing with complaints.

There were areas where the provider could make improvements and should:

• Review the practice’s system for the recording, investigating and reviewing of accidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the practice’s system for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities, specifically in relation to the completion of recommended actions arising in the legionella risk assessment, the provision of emergency lighting in the event of fire, protocols for used sharps, and staff immunity to vaccinations.
• Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are informed as to its purpose and their right to access footage.
• Review the practice’s complaint handling procedures to ensure contact details for alternative organisations are available to patients who do not wish to complain to the practice directly.