We carried out this announced inspection on 29 September 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 area team that we were inspecting the practice. They provided information which we took into account.

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

Parade Dental Practice Limited is in Bridgewater and provides NHS and private treatment to patients of all ages.

There is no level access for people who use wheelchairs and pushchairs. Car parking spaces, including those for patients with disabled badges, are available near the practice.

The practice was being redeveloped with the addition of ground floor access; and level access to a new reception area, new treatment rooms and other practice facilities including the renovation of current treatment room floors, and was due to be opened by the end of December 2017.

The dental team includes three dentists, two dental nurses, one dental hygienist and three receptionists. The practice has two 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 48 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

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

The practice is open: Monday to Friday 9am to 5pm

Our key findings were:

• The practice was 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 had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• 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. 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.

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

• Review its responsibilities as regards the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date and staff understand how to minimise risks associated with the use and handling of these substances.

During our inspection we spoke with five people who used the service, both dentists who provide dental treatment, one out of the two hygienists and both dental nurses. There were two dentists who provided dental treatment; one dentist provided treatment under the NHS and the other provided private treatment and also domiciliary visits for people who were unable to visit the practice. We looked at four treatment records of people who used the service to review how people’s treatment was delivered and assessed.

People spoken with told us the dentist they saw was “terrific, very gentle and they put you at ease when you are anxious”. Another person said “the dentist is very careful, I trust him to make a good decision and not to provide treatment unnecessarily”. A third person said “I think they are excellent and very good, they always explain treatment to you and there is no rush”.

The practice followed appropriate infection control procedures and related guidance. The practice also had systems in place to assess and monitor the service. Staff knew how to recognise signs of abuse in vulnerable adults and children who may visit the practice and what to do if they were concerned.