A patient we spoke with confirmed that he had given written consent to treatment as part of the treatment plan and they showed us a copy to demonstrate this.

During this visit we found that the provider had improved the assessment of patients. We found that since our inspection the provider had introduced new patient assessment records.

The practice had systems in place including current policies and procedures in regards to infection prevention and control. Procedures included the use of daily checklists for cleaning and safe systems of work. The practice had attained positive feedback from external infection control audits which showed that they were complying with relevant guidance on best practice.

During this visit we were told that the justification for antibiotics was recorded in the patient’s record card, together with dose, frequency and quantity. Medicines were prescribed and given to people appropriately. The records had improved in terms of being clearer, more accurate and in greater detail about the patients medical and health needs.

Following our previous visit the practice had worked with a quality monitoring company as well as the local commissioners to ensure that regular and robust processes were in place to monitor and evaluate the quality and of treatment.

We did not discuss the issues or concerns regarding the reviewed outcomes with patients attending the surgery for treatment.

We carried out this announced inspection on 13 July 2017 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. They provided information which we took into account.

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

Khan Dental - Allerton Dental Care is in a residential suburb of Liverpool and provides dental care and treatment to adults and children on an NHS and privately funded basis.

There is level access to the practice and car parking is available nearby.

The dental team includes two dentists, three dental nurses and two receptionists. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

We received feedback from 39 people during the inspection about the services provided. The feedback provided was positive about the practice. We also received feedback from four people through the ‘Share Your Experience’ facility on the CQC website.

During the inspection we spoke to the principal dentist, two dental nurses and a receptionist. 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 5.00pm

Our key findings were:

• The practice was clean and appropriately 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.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ 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 most risks but the fire risk assessment was not practice specific and not all risks associated with the use of sharps had been reduced. The provider arranged a fire risk assessment after the inspection.
• The practice had staff recruitment procedures in place, but the prescribed information was not available for all staff.

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

• Review the protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes ensuring recruitment checks, including references, are carried out and suitably recorded.
• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities.
• Review the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment of all staff.
• Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are fully informed as to its purpose and their right to access footage.
• Review the practice’s audit protocols to help improve the quality of the service. The practice should also check where appropriate, that audits have documented actions and learning points which are shared with staff, and the resulting improvements can be demonstrated.