We carried out this announced inspection on 20 February 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.

We told the NHS England area team that we were inspecting the practice. They did not provide any information of concern.

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

Athersley dental practice is in Barnsley and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes six dentists (one of whom is a locum dentist), 11 dental nurses (four of whom are trainee dental nurses), a practice manager and two receptionists. The practice has three treatment rooms and two instrument processing 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 23 CQC comment cards filled in by patients this information gave us a positive view of the practice.

During the inspection we spoke with three dentists, two dental nurses, two receptionists 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 Friday 8:45am – 5:45pm

Saturday 9am – 1pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• The process to monitor emergency medicines and life-saving equipment could be improved.
• The practice had systems to help them manage risk.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children. The process to monitor safeguarding training could be improved.
• Recruitment, appraisal and induction processes could be improved.
• The clinical staff did not always provide 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 but some areas could be improved. 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 the practice's staff induction, appraisal and recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review staff training and monitoring procedures and ensure that all staff had undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review the practice's protocols for completion of dental care records and the frequency of taking X-rays taking into account guidance provided by the Faculty of General Dental Practice.
• Review the practice’s protocols and procedures for promoting the maintenance of good oral health taking into account guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’.

We spoke privately with three people who were attending the practice for check ups or treatment. They told us that they were "very happy" with all aspects of the service. They told us that staff were "very good" and “very friendly". People said that the dentist always explained treatment options to them. One person told us, "I have known the dentist for over twenty years. He always explains things fully to me so that I know what is needed. I can then decide what to do." People spoken with said that they felt safe in the care of the dentists and that they found all members of the staff team polite and respectful. One person said, "they are very good here. All my family come and we all like the dentist and other staff." People spoken with told us that they had no worries or concerns about the practice. One person said, "I can talk to my dentist about anything. They know me very well here."

We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection. People spoken with said that the surgery was always clean. One person said, "I've always found it very clean."

The provider had an appropriate system in place for gathering, recording and evaluating information about the quality and safety of care the service provided. People who used the service and their representatives were asked for their views about their care and treatment.