We carried out this announced inspection on 12 February 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

Simkins Dental Care is in Davyhulme, Manchester and provides private treatment for adults and NHS treatment for children.

The practice is accessed by steps and is not accessible to wheelchair users. Car parking spaces are available directly in front of the practice with additional on-street parking available.

The dental team includes the principal dentist and two associate dentists, four dental nurses, five dental hygiene therapists, a receptionist and a practice manager. The practice has four treatment rooms.

The practice is owned by a partnership 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 Simkins Dental Care is the principal dentist.

On the day of inspection, we collected 57 CQC comment cards filled in by patients. Patients were positive about staff, the premises and the services provided.

During the inspection we spoke with three dentists, 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 Friday 8.30am - 6.00pm

Saturdays 9.00am - 2.00pm

Our key findings were:

• The premises were clean and well maintained.
• The provider had infection control procedures which broadly reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Some of the equipment required replacing.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures with the exception of carrying out Disclosure and Barring Service (DBS) checks.
• 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 culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the security of NHS prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice; In particular, carrying out DBS checks.

• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are clearly identified.

• Review the practice’s protocols to ensure audits of infection prevention and control are undertaken at six monthly intervals. The practice should also review the processes to manually clean instruments.

We saw patients were given a treatment plan that included details of the treatment and the costs. Where the patient was a child we saw consent forms had been signed by a parent.

We observed staff were friendly and polite and treated patients with respect. We observed staff taking phone calls and saw patients were offered appointments at a time to suit them.

We spoke with four patients who gave positive comments about the care and treatment they received at the practice. Comments included: “They are always nice and smiling.” “Always polite and friendly.” “The service is excellent, I have no problems.” “I have total confidence in them.” “They are brilliant; they have been fantastic with me.”

There was a separate decontamination room located on the ground floor. We observed correct practices for the decontamination and sterilisation processes were undertaken as per health technical memorandum (HTM) 01-05 requirements.