We carried out this announced inspection on 18 May 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 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

Southbrook Dental Practice is in Bradford and provides NHS and private treatment to adults and children.

Due to the nature of the premises access for wheelchair users and those with limited mobility is limited. On street car parking spaces are available near the practice.

The dental team includes two dentists, three dental nurses, one dental hygienist, one receptionist and two administrative staff. 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 received feedback from 29 patients. This information gave us a positive view of the practice.

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

The practice is open:

Monday and Thursday from 10:00am to 4:30pm

Tuesday and Wednesday from 9:00am to 4:30pm

Friday from 10:00am to 12:00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance. Some improvements were required to the process for validating the equipment used in the decontamination process.
• Staff knew how to deal with emergencies. Medicines and life-saving equipment were available but adjustments were needed to the contents and the storage of the kit.
• The practice had some systems to help them manage risk. The fire risk assessment required more detail.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.

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

• Review availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the storage of dental care products requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance.
• Review the practice’s testing protocols for equipment used for cleaning used dental instruments taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the practice's environmental risk assessments, ensure a fire risk assessment is undertaken and the necessary actions are implemented.
• Review the protocols and procedures for use of X-ray equipment taking into account Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.

• Review the practice’s audit protocols to ensure audits of infection prevention and control are undertaken at regular intervals to help improve the quality of service. Practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

We spoke with one person who used the service and they said the dentist had a "professional approach" and was "good with kids".

We found that the dentist fully explained any necessary care and treatment with people to ensure they were fully informed before signed to consent. We also found that people's care and welfare was central to the care provided and people's risks were assessed and managed appropriately.

We found that the practice was visibly clean and the necessary decontamination standards were being met. In addition, we found that the provider had a sound complaints process and staff clearly understand the processes for managing any complaints.