We carried out this announced inspection on 16 August 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 providing well-led care in accordance with the relevant regulations.

Background

Saddleworth Dental Clinic is in the village of Uppermill, Oldham, and provides private treatment to adults and NHS treatment to children.

Narrow steps up to the practice prevent access to wheelchair users and those with wide pushchairs. Handrails are provided for patients with impaired mobility. Car parking spaces are available opposite the practice.

The dental team includes one dentist, two dental nurses (one of whom is a trainee), three part time dental hygienists and a receptionist. The practice has two treatment 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 27 CQC comment cards filled in by patients

During the inspection we spoke with the dentist and both dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Wednesday 9am to 6pm,

Thursday 8am to 6pm,

Fridays and Saturdays 9am to 12.30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Improvements were needed to the life-saving equipment available
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Evidence of training was not available for the dental hygienists.
• 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.

• Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.

• Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• 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 protocols for recording in the patients’ dental care records or elsewhere, a grading of the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017.

Patients who expressed a view to us were positive about the service provided at Saddleworth Dental Clinic. Comments included, “As someone who finds coming to the dentist “traumatic” the ambience and manner in which [the dentist] and his staff creates takes away a lot of the stress”, “excellent service … staff very friendly” and “very professional, caring and flexible from all members of staff”.

Patients were routinely asked for their consent to any treatment. This consent was based on being given clear and understandable information by the dental team.

Assessments of the patient's dental needs were routinely undertaken. Sufficient numbers of staff, with sufficient training and qualifications were available to meet the needs of patients.

Hygiene within the practice was maintained to minimise the risk of cross infection.

Patients were confident that if they had any cause for complaint they could raise the issue with staff at the practice.