We carried out this announced inspection on 9 May 2019 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

Saltburn Dental Practice is in the centre of Saltburn and provides private and NHS dental treatment to adults and children. Parking is available outside the practice with access to public transport nearby.

The practice has surgeries on the ground and first floor and access for people who use wheelchairs and those with pushchairs.

The dental team includes three dentists (one of whom is a newly qualified dentist), one dental hygienist, five dental nurses and two receptionists. The practice has three treatment rooms and two decontamination 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 nine CQC comment cards filled in by patients. All the comment cards were extremely positive about the service and care received.

During the inspection we spoke with three dentists, three dental nurses and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 8:30am-5:30pm, Tuesday 8:30am-5.00pm, Wednesday 8am-2pm, Thursday 8:30am-5pm and Friday 8:30am-4pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. We noted that some medical emergency equipment was omitted from the emergency kit.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had followed recruitment procedures, we noted that the process for obtaining photographic identification of staff and Disclosure and Barring Service (DBS) checks required review.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked patients for feedback about the services they provided.

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

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Review the practice's storage of dental care records to ensure they are stored securely.

We found that staff were courteous when they responded to people contacting the service. We saw that information about their treatment options and costs was on display in the waiting room. Three people were visiting the hygienist when we inspected. We found that they were satisfied with the service. The practice completed regular satisfaction surveys with patients. Respondents were very complimentary about the dental practice. People who had treatment were given all the information they needed to make a decision about which option to take.

Records held by the practice showed that people’s treatment considered relevant medical history and showed that in-depth screening and checks were carried out during consultations. The staff had been trained to deal with foreseeable medical emergencies.

The practice had procedures to ensure that the risk of cross contamination and infection were managed and minimised and that equipment was sterilised, stored appropriately and used within the specified timescales. People who received treatment at the dental practice were treated in an environment that was clean and hygienic.

When we looked at the recruitment process, we found that staff were recruited appropriately and that pre-employment checks had been carried out. The practice had an effective monitoring system in place, which ensured the service always operated safely and in line with expectations for dental services.

People said that they were happy with the service provided. They felt their dignity was maintained and their privacy protected.