We carried out this announced inspection on 27 June 2017 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 Cheshire and Merseyside area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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

Saltney Dental Practice is close to the centre of Saltney and provides treatment to adults and children on an NHS and privately funded basis.

There is level access at the front entrance to the practice to facilitate access for people who use wheelchairs and for pushchairs. Car parking is available near the practice.

The dental team includes a principal dentist, a dental hygiene therapist, two dental nurses, one of whom is also a treatment co-ordinator, and a receptionist. The practice has three 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.

We received feedback from 40 people during the inspection about the services provided. The feedback provided was positive about the practice.

During the inspection we spoke to the dentist, the dental hygiene therapist, one of the dental nurses and the receptionist. We looked at practice policies, procedures and other records about how the service is managed.

The practice is open:

Monday to Friday 8.30am to 5.30pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. All the recommended medical emergency medicines and most of the equipment was available with the exception of self-inflating resuscitation bags/masks which the provider ordered immediately.
• The practice had systems in place to help them manage risk.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff provided patients’ care and treatment in line with current guidelines. The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had staff recruitment procedures in place. Checks were not carried out for temporary staff.

There were areas where the provider could make improvements and should:

• Review the practice’s protocol for maintaining accurate, complete and detailed records relating to the employment of staff. This includes ensuring recruitment checks for temporary staff are carried out and suitably recorded.
• Review the practice’s protocols in relation to the use of closed circuit television to ensure staff and patients are fully informed as to their right to access footage.

A recent satisfaction survey of 20 patients recorded very positive responses, with 100% scores of either very good or excellent for questions about explaining treatment, courtesy, and advice. The surgery on the ground floor was accessible for people using a wheelchair and a patients’ toilet was accessible for people with mobility difficulties. Post-treatment information was provided for each person following their visit. The practice offered a number of additional services including guaranteed urgent appointments and home visits.

Patient records were all kept electronically. They contained all the relevant clinical information including a detailed medical history form that all new patients to the practice completed. The surgery had procedures and equipment in place for dealing with emergencies.

The premises appeared clean and tidy throughout. There was a separate decontamination room for cleaning dental instruments and this was well-equipped. All of the staff received regular training and attended six weekly staff meetings. The provider kept a record of all complaints, concerns and compliments received and how any complaints were handled.