We carried out this announced inspection on 10 January 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

K S Hunjan & Associates Dental Practice Bradford provides NHS and private treatment to adults and children. Treatments under conscious sedation are available upon request.

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 five dentists, six dental nurses and a decontamination nurse. The practice has four 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 K S Hunjan & Associates Dental Practice Bradford is one of the dentists.

On the day of inspection, we collected 46 CQC comment cards filled in by patients.

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

The practice is open:

Monday to Friday from 9:00am to 5:30pm

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. Appropriate medicines and life-saving equipment were available.
• Improvements could be made to the process for managing the risk associated with fire.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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. Improvements could be made to the storage of paper dental care records and the protocol for the use of closed circuit television.
• 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 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.

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

• Review the practice’s fire risk assessment and ensure that ongoing fire safety management is effective.
• Review the practice's storage of dental care records to ensure they are stored securely.
• Review the practice’s protocols for the use of closed circuit television (CCTV) cameras taking into account the guidelines published by the Information Commissioner's Office.
• Review staff training to ensure that dental nursing staff who assist in conscious sedation have the appropriate training and skills to carry out the role, taking into account guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015'.

We looked at the infection control and found that there were effective systems in place to reduce the risk and spread of infection.

We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection. People we spoke with told us the practice was always clean and tidy.

People we spoke with told us staff explained all the procedures and treatments to them and respected their decisions about their treatment and care. One person said, "it's absolutely fantastic here the dentists are wonderful they make it an enjoyable experience." Another person said "it's alright here the dentist always puts me at ease."

We asked two people if they felt safe at the practice. They both said "yes." One person said "my relative had an emergency and they saw them within 12 hours." Another person said, "the dentist always explains to me all the different choices."

We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection. People we spoke with told us the practice was always clean and tidy. The provider had a system in place for gathering, recording and evaluating information about the quality and safety of care the service provided. People who used the service were asked for their views about their care and treatment.

A member of staff and the dentist also promoted oral health education including preventative advice at local schools and for members of the local community at community centres.

This service is due to undertake major refurbishment with the next three months, a ground floor surgery, reception/waiting area and better access for disabled people are to be established on the ground floor.