We carried out this announced inspection on 16 April 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Reedyford Dental Centre is in Nelson, Lancashire and provides NHS and private dental services to adults and children.

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

The dental team includes three dentists, seven dental nurses (four of whom are trainees) and a practice manager. The practice has five treatment rooms.

The practice is part of a good practice certification scheme and a training practice for trainee dentists.

The practice is owned by an individual who is the principal dentist. 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 nine CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, three dental nurses 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 8:30am- 5pm.

Our key findings were:

• The practice appeared 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. We noted the oropharyngeal airway tubes were out of date. These were re-ordered during our visit.
• The practice’s approach towards risk management of Legionella could be improved.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Not all staff had completed level two safeguarding training.
• 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 practice 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 practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

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

• Review the safeguarding training of staff ensuring they are trained to an appropriate level.
• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the 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.

Three patients we spoke with told us that they were asked to sign their consent to agree to be treated by the dentist. They also told us the dentist discussed any treatments with them. Patients were told about the costs of the treatment. Patients who used the service were aware and agreed to any treatment required at each visit to the dental practice.

Three patients told us, "It is a good dentists but I would like to get a dentist closer to my home", "I am happy with the service we get" and "We are happy enough with the surgery". All three patients thought staff were helpful and pleasant. Patients thought they were provided with a good service.

Each patient had a treatment plan and a medical record which was updated at each visit. This ensured records were up to date and future treatments were undertaken in a planned way for the benefit of patients.

There were robust safeguarding procedures in place to help keep people safe.

Staff were well trained in reception, assisting in surgery and the decontamination and sterilising of equipment to ensure they were able to deliver effective care.