We carried out this announced inspection on 6 June 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.

We told the NHS England Cheshire and Merseyside area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

Neston Dental Care is located in the centre of Neston and provides treatment to patients of all ages on an NHS and privately funded basis.

There is one step at the front entrance to the practice with a handrail positioned alongside to assist patients with limited mobility. There is level access to facilitate entrance to the practice for people who use wheelchairs and for pushchairs at the rear of the practice. Car parking is available in the practice’s own car park at the rear of the practice.

The dental team includes four dentists, one dental hygienist / therapist, four dental nurses and one receptionist. The team is supported by a practice manager.

The practice has three treatment rooms.

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.

We received feedback from 37 people during the inspection about the services provided. We also received feedback from seven people via the Share Your Experience facility on the CQC website. The feedback provided was positive about the practice.

During the inspection we spoke to two dentists, two dental nurses, the receptionist and the practice manager. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open: Monday 9.00am to 7.00pm and Tuesday to Friday 9.00am to 5.00pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place.
• Staff knew how to deal with emergencies. The recommended medical emergency medicines and equipment were not all available but the manager ordered these immediately.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• The practice had systems in place to help them manage risk.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had staff recruitment procedures in place which could be improved.

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

• Review the protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes ensuring recruitment checks are carried out and suitably recorded.
• Establish whether the practice is in compliance with its legal obligations under the Ionising Radiations Regulations 1999 and the Ionising Radiation (Medical Exposure) Regulations 2000, specifically in relation to the appointment of a Radiation Protection Adviser, (RPA), and notification to the Health and Safety Executive of the use of radiation on the premises. The provider submitted evidence of the appointment of an RPA after the inspection.