We carried out this announced inspection on 12 March 2019 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

Precision Dental Clinic is in Stockport and provides NHS and private treatment to adults and children.

The practice has a portable ramp to facilitate access to the practice for wheelchair users. Car parking spaces are available near the practice.

The dental team includes two dentists, one dental nurse, one receptionist and a practice manager. The practice has one treatment room.

The practice is owned by a partnership 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 Precision Dental Clinic is one of the principal dentists.

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

During the inspection we spoke with one dentist, the dental nurse, the 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 to Thursday from 9am to 5pm

Our key findings were:

• The practice appeared clean and well maintained.
• Infection control procedures did not reflect published guidance in all areas.
• Staff had completed training in how to deal with medical emergencies. Not all medical emergency equipment was in date.
• The practice had some systems to help them manage risk to patients and staff.
• Staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had staff recruitment procedures. 
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked patients for feedback about the services they provided.
• The provider had suitable information governance arrangements.

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

• 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.’ In particular ensuing water temperatures reach the recommended limit.  
• Review the process to ensure all medial emergency equipment is in date taking into account the guidelines issued by the resuscitation council and the General Dental Council, in particular Paediatric AED pads and needles to administer adrenaline.
• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice. In particular, immunisation status or an adequate risk assessment.
• Review the practice’s protocols to ensure audits of infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.