We carried out this announced inspection on 25 July 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 did not provide any information.

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

Princes End Dental Practice is in Tipton and provides NHS and private treatment to patients of all ages. The practice is situated in a purpose built NHS health centre which provides many other health services in addition to dentistry. There was another dental clinic within this health centre and they were separately registered with the CQC. This inspection focused on Dr Azam and Dr Da Costa’s registered dental clinic only. Some areas of the dental practice were shared by both dental practices (such as the waiting area and the decontamination rooms).

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including six for patients with disabled badges, are available immediately outside the practice. There is a large car park for up to 130 cars.

The dental team includes one dentist and three dental nurses (two of whom are trainees). The dental nurses also carry out reception duties. The senior dental nurse also is responsible for managerial duties. The practice has one treatment room although other spare treatment rooms are available.

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 Princes End Dental Practice was the senior partner.

On the day of inspection we collected 38 CQC comment cards filled in by patients and spoke with three other patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist and three dental nurses. We also spoke with an external contractor who is responsible for conducting and maintaining many aspects of health and safety at the practice. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between 9am and 5pm on Monday to Thursday. The practice is closed on Fridays.

Our key findings were:

• The practice was clean and patients confirmed this.
• The practice did not consistently follow recommended guidance regarding the maintenance of one item of their infection control equipment.
• The practice had infection control procedures which reflected published guidance. We identified some necessary improvements and these were actioned promptly.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. One item was missing although this was available within the same building in the adjacent dental practice. The missing item was promptly ordered.
• 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 contact details of relevant protection agencies required updating.
• 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 availability of an interpreter services for patients who do not speak English as a first language.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance. They should also review the practice’s waste handling policy and procedure to ensure gypsum waste is segregated and disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Establish whether the practice is in compliance with its legal obligations under Ionising Radiation Regulations (IRR) 99 and Ionising Radiation (Medical Exposure) Regulation (IRMER) 2000.
• Review the protocol for completing accurate records relating to the recruitment of staff. This includes establishing the immunisation status of clinical staff members and ensuring these are updated throughout the course of the individual’s employment.