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

St Michael’s Dental Practice is in South Shields and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. The practice has three treatment rooms, all on the first floor. A stairlift is available for those who require help with ascending the stairs. Car parking spaces are available near the practice.

The dental team includes three dentists (one of whom is the principal dentist), six dental nurses (one of whom is a trainee), a practice manager and a receptionist.

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 Michael’s Dental Practice is the principal dentist.

On the day of inspection, we collected 49 CQC comment cards filled in by patients. These provided a positive view of the practice.

During the inspection we spoke with three dentists, four 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 9am to 5.30pm

Tuesday and Wednesday 9am to 6pm

Thursday and Friday 9am to 5pm

Saturday 9am to 12pm by appointment only

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. Appropriate medicines and life-saving equipment were available. The practice should review the storage of their medical drugs and equipment.
• The practice had systems to help them manage risk to patients and staff. They should review their Legionella risk assessment to ensure all actions are completed.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures. They should review their protocols for undertaking Disclosure and Barring Service (DBS) checks, or a risk assessment to mitigate the risk of not doing this, prior to employment.
• The clinical staff provided patients’ care and treatment in line with current guidelines. The practice should review their protocols for carrying out treatment in a domiciliary setting to ensure it reflects national guidance.
• 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. Staff attended local organisations to provide oral health education and the principal dentist was one of the founding members of a dental health charity in Nepal.
• 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 practice's protocols for medicines management and ensure all medical emergency drugs and equipment are stored safely and securely.
• Review the practice's Legionella risk assessment and implement any recommended actions, taking into account the guidelines issued by the Department of Health in the 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 recruitment procedures to ensure that appropriate DBS checks are completed prior to staff commencing employment at the practice.
• 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”.

People told us they were happy with the service provided. One person with whom we spoke said, “I’ve been coming here for a number of years and I’ve never had a problem” and “I wouldn’t be coming here if I didn’t think they were good.” Another person told us, “It’s really good here. I’ve been coming here since I was a child. I get a good service from all the staff here.”