We carried out this announced inspection on 25 September 2018 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

Osgodby dental centre is in Middlesbrough and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice, including two designated spaces for blue badge holders.

The dental team includes six dentists (including the principal dentist), 12 dental nurses (one of whom is a trainee), a dental therapist, a practice manager and a receptionist. The practice has six 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.

On the day of inspection, we collected 40 CQC comment cards filled in by patients. These provided us with a positive view of the practice.

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

The practice is open:

Monday, Tuesday and Wednesday 8am to 5.30pm

Thursday 8am to 7pm

Friday 8am to 2pm.

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 -apart from a child air mask and airways.
• The practice had suitable systems to help them manage risks. The provider needed to review their control measures for Legionella and their protocols for responding to significant events.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures. The process for obtaining photographic identification of staff required reviewing.
• 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 and culture of continuous improvement.
• 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.
• The practice had suitable information governance arrangements.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff, in particular photographic identification.
• Review the practice's Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having 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 system for recording, investigating and reporting incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the guidelines set out by the British Society for Disability and Oral Health when providing dental care in domiciliary settings such as care homes or in people’s residence.

We spoke with six people who used the service. The people we spoke with were very complimentary about the care they received. People confirmed that they saw the dentist on a regular basis. They told us the care they received was excellent. One person we spoke with told us, “I am very happy with everything all of my family come here even my daughter and her children.” Another person said, “I was so nervous about the dentist, but they talked to me and explain everything to me which has made me feel so at ease.”

People experienced care, treatment and support that met their needs and protected their rights.

We found that people had their privacy and dignity respected. People told us that if they needed to see the dentist in an emergency they would always try and fit them in.

We found that people were protected from the risk of infection as care was delivered in a clean and hygienic environment.

We found that suitable checks were not always undertaken to ensure people were cared for, or supported by, suitably qualified, skilled and experienced staff.

The practice had a system in place for dealing with complaints. People told us that they felt comfortable in raising a concern or complaint with staff working at the practice.