We carried out this announced inspection on 3 September 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

Leeds City Dentalcare Limited is in Leeds and provides private treatment to adults. They also have an NHS contract for patients who are exempt from paying NHS charges.

There is access for people who use wheelchairs at the rear of the premises using a portable ramp. Car parking spaces are available near the practice.

The dental team includes five dentists, four dental nurses, two dental hygienists, a receptionist, a deputy practice manager and a practice manager. The practice has five treatment rooms. The premises is currently undergoing refurbishment to add an additional surgery, a re-wiring of the building and work to extend the car park at the rear of the practice.

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 Leeds City Dentalcare Limited is the practice manager.

On the day of inspection, we collected 19 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, three dental nurses 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, Wednesday and Friday from 8am to 5pm

Tuesday from 8am to 5.30pm

Thursday from 8.30am to 6pm

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. On the day of inspection not all equipment to deal with medical emergencies was available.
• The practice had systems to help them manage risk to patients and staff.
• The practice staff 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 and took care to protect their privacy and personal information.
• The provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and 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 process for ensuring equipment to manage medical emergencies is readily available taking into account the guidelines issued by the Resuscitation Council (UK).
• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health (COSHH) Regulations 2002, to ensure risk assessments are undertaken.

We carried out this inspection as part of our schedule of inspections to check on the care and welfare of people who used this service. The inspection was announced, which meant the provider and the staff knew we were visiting. On the day of our inspection we spoke with five patients, four staff and looked at six treatment records.

People we spoke with told us they consented to treatment. "The dentist explains everything". "You have enough information to help you make a choice". We saw that people who used the service signed consent to treatments.

The complaints procedure was on display in the waiting room. People we spoke with said, "I have had no cause to complain, but if I did I know who I need to go to and what to do".

A dental nurse demonstrated that decontamination practices ensured that used dental equipment was suitably cleaned and sterilised. Records showed the cleaning regimes followed by staff.

We observed that people were communicated with in a professional and friendly manner and care and treatment was planned and delivered in a way that ensured people's safety. We saw people were cared for and treated by staff that had the appropriate knowledge and skills.