We carried out this announced inspection on 3 January 2019 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 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

Lowe House Dental Care is near the centre of St Helens and provides NHS and private dental care for adults and children.

There is level access to facilitate entrance to the practice for people who use wheelchairs and for people with pushchairs. Car parking is available outside the practice.

The dental team includes the principal dentist, an associate dentist, a dental hygiene therapist, four dental nurses and a receptionist. The dental team is supported by a practice manager. The practice has three treatment rooms.

The practice is owned by a partnership 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 Lowe House Dental Care is the principal dentist.

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

During the inspection we spoke to two dentists, dental nurses, the receptionist 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, Thursday and Friday 8.30am to 5.00pm

Tuesday 8.30am to 7.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with medical emergencies. Appropriate medicines and equipment were available.
• The provider had staff recruitment procedures in place. References were not routinely obtained.
• Staff provided patients’ care and treatment in line with current guidelines.
• The dental team provided preventive care and supported patients to achieve better oral health. Oral health education clinics were provided for children.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took account of patients’ needs.
• The provider had a procedure in place for dealing with complaints. Staff were not aware of the Duty of Candour.
• The practice had a leadership and management structure in place.
• The provider had systems in place to manage risk.
• Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.

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

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice, and to ensure accurate, complete and detailed records, including references, are maintained for all staff.
• Review the practice's waste handling protocols to ensure waste, specifically gypsum waste, is segregated and disposed of in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01.
• Review the practice's protocols and procedures for ensuring staff are up to date with recommended training and their continuing professional development, and that their training needs are identified and met.
• Review the practice's complaint handling procedures and staff awareness of their responsibilities in relation to the duty of candour, to ensure compliance with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.