We carried out this announced inspection on 28 March 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 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

Mr Tariq Idrees - Carisbrook is in Whitefield, Manchester and provides private treatment to adults and children, and NHS treatment to a small number of adults and children.

There is a ramp which provides access for people who use wheelchairs and those with pushchairs. The practice has a large car park, which includes spaces for blue badge holders.

The dental team includes six dentists, an orthodontist, an orthodontic therapist, seven dental nurses (two of which also work on reception), a dental hygienist, two dental hygiene therapists, a treatment & referral co-ordinator, a reception manager and a practice manager. The practice has five 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 Mr Tariq Idrees - Carisbrook is the practice manager.

On the day of inspection, we collected 12 CQC comment cards filled in by patients. Patients were positive about all aspects of the service the practice provided.

During the inspection we spoke with three dentists, dental nurses, the reception manager 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 & Thursday 9am to 5pm

Tuesday & Wednesday 8.30am to 6pm

Friday 8.30am to 5pm

Saturdays 9am to 1pm by prior appointment only

Our key findings were:

• The premises were clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. The provision and checking of medicines and life-saving equipment should be reviewed.
• The provider 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. Audit processes and record keeping could be reviewed to ensure consistency.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Improvements could be made to the process for managing the risks associated with hazardous substances, sharps and Legionella.
• The provider 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 practice's protocols to ensure that patients who are prescribed antibiotics are provided with the appropriate patient information for the medicine provided.

• Review the practice’s protocols for the use of closed-circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.

• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, the local rules for the OPG (Orthopantomogram), and the location of, and identification of isolation switches.

• Review the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, sharps, latex and the storage of hazardous substances.

• Review the practice’s protocols to ensure improvements can be demonstrated as a result of audits of radiography.