Further to the outcome of a previous inspection, carried out in November 2015, we carried out an announced focused inspection relating to the safe and well led provision of services on 2 August 2016 to ask the practice the following key questions;

Are services safe in relation to staff recruitment and safeguarding training?

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Background

CQC inspected the practice on 20 November 2015 and asked the provider to make improvements regarding:

• Regulation 18 HSCA (RA) Regulations 2014 Staffing

• Regulation 19 HSCA (RA) Regulations 2014 Fit and Proper Persons employed

We checked these areas as part of this focused inspection and found these had been resolved.

High Street Dental Centre is a dental practice providing mainly NHS and some private treatment and caters for both adults and children. The practice is situated in a converted commercial property. The practice has four dental treatment rooms and a separate decontamination room for cleaning, sterilising and packing dental instruments for the three dental treatment rooms on the first floor and a reception and waiting area. One of the dental treatment rooms is situated on the ground floor enabling disabled access. To facilitate access to this treatment room, a hydraulic lift is in place to help wheelchair users and other patients with mobility impairments negotiate the two steps leading to this treatment room.

The practice has six dentists, of which one is on maternity leave and one is a locum dentist, a dental therapist, five dental nurses three of whom are in training, two receptionists and a practice manager.

The practice’s opening hours are 8:00am – 5:30pm Monday to Friday. Extended hours are also available until 7pm on Thursday. There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service.

There was no registered manager at the time of our inspection at this location. We were shown evidence which confirmed the current Practice Manager was going through the CQC registration process to become 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.

The inspection was carried out by a CQC inspector.

Our key findings were:

• Staff had received safeguarding training appropriate to their roles.

• Staff recruitment files contained essential information in relation to Regulation 19, Schedule 3 of Health & Social Care Act 2008 (Regulated Activities) Regulations 2015.

We spoke to five people who used the service and all of the people we spoke with were satisfied with the service they received.

We spoke to people in the waiting area and this was comfortable. People were able to relax before and after treatment.

People told us that they were able to make informed decisions. They said they had enough information to make a decision about their treatment options.

We were told that the dentist fully explained the options about any treatment they were being offered. People said they were able to ask any questions and that staff explained things to them clearly.

We carried out an announced comprehensive inspection on 20 November 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 not providing well-led care in accordance with the relevant regulations

Background

High Street Dental Centre is a dental practice providing mainly NHS and some private treatment and caters for both adults and children. The practice is situated in a converted commercial property. The practice has four dental treatment rooms and a separate decontamination room for cleaning, sterilising and packing dental instruments for the three dental treatment rooms on the first floor and a reception and waiting area. One of the dental treatment rooms is situated on the ground floor enabling disabled access. To facilitate access to this treatment room, a hydraulic lift is in place to help wheelchair users and other patients with mobility impairments negotiate the two steps leading to this treatment room.

The practice has five dentists a dental hygienist and five dental nurses four of whom were in training and on a recognised training course. All of the dental nurses who were qualified were registered with the General Dental Council. Supporting the clinical staff was a practice manager who had previously trained as a dental nurse and two reception staff. The practice’s opening hours are 8:00am – 5:30pm Monday to Friday. There are arrangements in place to ensure patients receive urgent medical assistance when the practice is closed. This is provided by an out-of-hours service.

The practice manager 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.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We collected eight completed cards and asked 26 patients for their feedback about the service during our visit. These provided a positive view of the services the practice provided.

We carried out an announced comprehensive inspection on 20 November 2015 as part of our planned inspection of all dental practices. The inspection was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• The practice had an empowered practice manager who provided robust leadership within the practice.
• Staff had been trained to handle emergencies. Appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice was visibly clean and well maintained.
• Infection control procedures were robust and the practice followed published guidance.
• The practice had a dedicated safeguarding lead and processes in place for referring safeguarding concerns to appropriate organisations.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The practice had enough staff to deliver the service.
• Staff we spoke with felt well supported by the practice manager and were committed to providing a quality service to their patients.
• All complaints were dealt with in an open and transparent way by the practice manager if a mistake had been made.
• The practice had a programme of clinical and non-clinical audit in place.

We identified regulations that were not being met and the provider must:

• Ensure recruitment arrangements include all necessary employment checks for all staff.

There were areas where the provider could make improvements and should:

• Keep accurate staff training records to confirm staff have the appropriate skills and knowledge to undertake their role.