We carried out this announced inspection on 5 November 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

Parkside Dental Care is in Irlam and provides NHS and private treatment to adults and children.

There is a small step to access the premises. A portable ramp is available for wheelchair users. Car parking spaces are available near the practice.

The dental team includes seven dentists, 11 dental nurses (three of whom are trainees), two dental hygiene therapists, two receptionists, a domestic cleaner and a practice manager. The practice has four 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 Parkside Dental Care is the principal dentist.

On the day of inspection, we collected 23 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two dental nurses, one receptionist 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, Tuesday and Thursday from 8:00am to 6:00pm

Wednesday from 8:00am to 7:00pm

Friday from 8:00am to 1:00pm

Alternate Saturdays from 9:00am to 4:00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures. Improvements could be made to the process for obtaining Disclosure and Barring Service (DBS) checks for the dentists.
• 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 provider was providing preventive care and supporting patients to ensure better oral health.
• 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 provider dealt with complaints positively and efficiently. Improvements could be made to the process for acknowleging complaints in a timely manner.
• The provider had suitable information governance arrangements.

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

• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken for all products.
• Review the practice's recruitment procedures to ensure that a valid DBS check is completed prior to new staff commencing employment at the practice.
• Review the practice's complaint handling procedures and establish and ensure complaints are acknowledged within the time frame set out in the practice’s policy.

We were informed that before patients agreed to any care or treatment, the procedure was fully explained to them. To help patients understand treatments, the practice used an electronic system called 'Communicator 2011' which used animation to explain and demonstrate a variety of treatments and dental hygiene methods.

One patient told us: "Treatments are fully explained, I never feel pressurised to have any treatments. I have had two crowns, everything was fully explained and I was very happy with the outcome".

We found that staff were trained in dealing with medical emergencies and cardio pulmonary resuscitation (CPR). We saw evidence of regular staff training and certificates in staff files. The clinic had emergency equipment available including a defibrillator, oxygen and emergency drugs.

A patient said "I travel some distance to get here, they are very efficient and reassuring. They listen to me".

The practice had its own decontamination room located on the first floor. A nurse talked us through the process and showed us the record of daily and weekly checks which had taken place.

One member of staff told us: "I think we are very supported by management here. Everybody is nice, everybody gets on, it a nice place to work".

The practice had a robust and effective systems in place to monitor the quality of the service provided.