We carried out this announced inspection on 4 December 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.

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

St Andrews Dental Centre Limited is in Hull and provides private treatment to adults and children.

There is permanent ramp access for people who use wheelchairs and pushchairs. Car parking spaces are available near the practice.

The dental team includes one dentist, four dental nurses (one of whom is the practice manager), a dental hygienist and a cleaner.

The practice has three surgeries, one on the ground floor and two on the first floor. One is currently not in use. A dedicated room for taking Orthopantomogram (OPG) X-rays and Cone beam computed tomography (CBCT) scans, a decontamination room for sterilising dental instruments, a staff room/kitchen and a general office.

The practice is owned by a company 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 St Andrews Dental Centre Limited was the principal dentist.

On the day of inspection we collected 40 CQC comment cards filled in by patients and spoke with one other patients. This information gave us a positive view of the practice.

During the inspection we spoke with the principal dentist, two dental nurses 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 8am – 5:30 pm

Tuesday & Thursday 8:30 am – 6pm

Wednesday 8am – 4pm

Friday 8am – 1pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had some systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 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.
• The practice dealt with complaints positively and efficiently.

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

• Review the accessibility of the medical emergency drugs and equipment within the practice.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).
• Review the protocols and procedures for the 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 policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice’s protocols for domiciliary visits taking into account the 2009 guidelines published by British Society for Disability and Oral Health in the document “Guidelines for the Delivery of a Domiciliary Oral Healthcare Service”.

We found that people’s treatment was always discussed with them and they understood the cost involved. People told us the dentist always discussed different options with them. One person said, “I am happy with the dentist he makes me feel relaxed.” Another person told us, “Yes all options were discussed and I took the course of treatment I felt was right for me.”

We saw that the practice had emergency equipment and drugs to help people if they become ill whilst receiving dental care. Staff had received training which was relevant to their role and they told us they felt well supported to undertake training.

People who used the service were asked for their opinion about the running of the practice and changes were made as result of any suggestions.