We carried out a focused inspection of Ripponden Dental Surgery on 9 July 2018.

The inspection was led by a CQC inspector who had remote access to a specialist dental adviser.

We undertook a comprehensive inspection of Ripponden Dental Surgery on 5 June

2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions where we found the registered provider was not providing well-led care in accordance with Regulation 17 ‘good governance’ of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Ripponden Dental Surgery on our website www.cqc.org.uk.

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

We undertook a follow up focused inspection of Ripponden Dental Surgery on 9 July 2018. This inspection was carried out to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was now meeting legal requirements.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations. The provider had made improvements to address the shortfalls identified and responded to the regulatory breach we found at our inspection on 5 June 2018.

Background

Ripponden Dental Surgery is in Sowerby Bridge and provides NHS and private treatment 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 two dentists, a visiting implantologist, three dental nurses, one dental hygiene therapist, one receptionist, a support manager and a practice manager. The practice has two 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 Ripponden Dental Surgery was the principal dentist.

During the inspection we spoke with the practice manager. We looked at practice policies and other records about how the service is managed.

The practice is open:

Monday to Thursday from 8:30am to 5:30pm

Friday from 8:30am to 12:30pm

Our key findings were:

• Processes to reduce the risks associated with fire, legionella and staff working without known immunity to the Hepatitis B virus had been implemented.
• Improvements had been made to the recruitment process.
• A process to receive safety alerts from the Medicines and Healthcare Products Regulatory Authority (MHRA) had been implemented.

We carried out this announced inspection on 5 June 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 not providing well-led care in accordance with the relevant regulations.

Background

Ripponden Dental Surgery is in Sowerby Bridge and provides NHS and private treatment to patients of all ages.

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

The dental team includes two dentists, a visiting implantologist, three dental nurses, one dental hygiene therapist, one receptionist, a support manager and a practice manager. The practice has two 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 Ripponden Dental Surgery was the principal dentist.

On the day of inspection, we collected 30 CQC comment cards filled in by patients and spoke with five other patients.

During the inspection we spoke with the principal dentist, two dental nurses, 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 8:30am to 5:30pm

Friday from 8:30am to 12:30pm

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.
• Improvements could be made to the systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Improvements could be made to the recruitment process.
• 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. They visited local schools to provide oral health education.
• The appointment system met patients’ needs.
• The practice had a 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.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice’s protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010.