We carried out this announced focussed inspection on 24 April 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions and in response to information we had received. 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 focussed our inspection on two of the five key questions:

• Is it safe?

• Is it effective?

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.

Background

Luton Dental Health Centre is located in Luton town centre and provides private treatment to adults.

There is ramp access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for blue badge holders, are available near the practice in the town centre car parks.

The dental team includes one dentist, two dental nurses and a practice manager. The practice manager is a trained dental nurse with a qualification in dental sedation nursing and assists during sedation treatment. The practice has one treatment room in use, but is currently refurbishing a second treatment room with the aim to increase capacity.

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.

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

The practice is open:

Tuesday and Thursday from 9.30am to 5pm.

Saturday from 9.30am to 1pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which 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 staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures. We found one staff member had applied for a Disclosure Barring Service (DBS) check at the time of the inspection. This was received after the inspection.
• The clinical staff provided patients’ care and treatment mostly in line with current guidelines.
• The practice offered conscious sedation to patients who may require this service. This was provided mostly in line with national guidance.
• The practice was providing preventive care and supporting patients to ensure better oral health.

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

• Review the practice's policies and procedures for obtaining patient consent prior to the day of treatment in relation to conscious sedation.

We spoke with two people who used the service. People said they were provided with information about the treatment and the cost of the various treatments. People told us they were satisfied with the care and treatment provided. One person said, "The dentist gives me two or three options and allows me to choose. I always have choices and he involves me with my treatment". Another person said, “I am happy with the care and treatment that the dentist provides. He has carried out treatments which I was told could not be done. I can smile again".

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People said the dentist answered their questions relating to their care and treatment satisfactorily. One person said, “Dr…always make sure I am sitting up and not lying down in the treatment chair if he has to explain anything to me. He repeats things to make sure I understand”. Another person said, “The dentist uses equipment which is up to date”.

We saw there were effective systems in place to reduce the risk and spread of infection. People said, “The practice was spotless”.

There were systems in place to deal with comments and complaints including providing people who used the service with information about that system.

We found that the service’s recruitment procedures were not consistent. Some staff were employed without the appropriate checks undertaken.