We carried out this announced inspection on 8 November 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.

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

Luton Dental Centre is in Bedfordshire and provides NHS and private treatment to patients of all ages.

There is ramp access through the rear of the building for people who use wheelchairs and pushchairs. Car parking spaces are available a short walk from the practice.

The dental team includes 13 dentists, 13 dental nurses (of which six are trainees) one dental hygienist, one dental hygienist therapist, nine receptionists, a practice manager and a cover manager. The practice has 11 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 the Luton Dental Centre was the provider.

On the day of inspection we collected 25 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with six dentists, five dental nurses, two receptionists 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 from 8am to 5.30pm

Tuesday from 8am to 7pm

Wednesday from 8am to 7pm

Thursday from 8am to 5.30pm

Friday from 8am to 5.30pm

Saturday from 8.30am to 1pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which mostly reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Staff recruitment procedures were in line with regulation. There was scope to improve the organisation of recruitment documents in order that full oversight of these was maintained.
• 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 appointment system met patients’ needs.
• The practice had effective leadership. 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 practice dealt with complaints positively and efficiently.

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

• Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

• Review the practice’s protocols for ensuring that all clinical staff have adequate immunity for vaccine preventable infectious diseases.

• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development (CPD).

We carried out an announced comprehensive inspection on 22 October 2015 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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.

Luton Dental Centre is a large general dental practice in central Luton, Bedfordshire offering NHS and private dental treatment to adults and children.

The premises is currently located over two floors and consists of eight treatment rooms; a reception area and waiting areas on each floor. The practice is currently undergoing development to include a designated decontamination area and two further treatment rooms.

The staff at the practice consist of a practice manager, a principal dentist, 11 associate dentists, four dental nurses, eight trainee dental nurses, three dental hygienist/therapists and eight receptionists. The principal dentist is the registered manager.

A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• There was a comprehensive induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclaves, fire extinguishers, oxygen cylinder and the X-ray equipment.

• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• The practice kept up to date with current guidelines when considering the care and treatment needs of patients.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients and waiting times were kept to a minimum.

• There was an effective complaints system and the practice was open and transparent with patients if a mistake had been made.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring and professional.

• We received feedback from 13 patients. Common themes were patients felt they received very good service from staff who were kind, friendly and professional.

• There was an effective system in place to act on feedback received from patients and staff.

• There were systems in place to assess, monitor and improve the quality of service provided.

During our visit to Luton Dental Centre on 14 November 2012 we spoke with six people who were waiting to see one of the dentists. We also looked at a variety of comments made by people as part of the centres quality surveys. The comments were all very positive and included, “I am really happy with this practice” and “Everyone does a great job.” We observed reception staff helping people to make appointments that best suited them in an effort to reduce the number of people who failed to attend their appointments.

We spoke with people who told us they felt involved in their treatment. One person said, “You can ask as many questions as you like and they will answer them.” The records that we looked at and the conversations we had with people confirmed that treatment options were discussed with the person using the service.

The centre had sufficient processes in place to ensure that treatment was delivered safely. All areas of the centre were clean and tidy and there were robust infection control processes in place to ensure people were treated safely.

People told us that they would be confident to make a complaint if it were necessary and we saw that people were given the appropriate information to do so.