We carried out this announced inspection on 10 January 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

The Dental Practice - Valley Shopping Village Kingsway is in Gateshead and provides NHS and private treatment to adults and children.

The practice occupies a single storey building within a business park with level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes two principal dentists, four dental nurses (who also perform reception duties) and a dental hygienist. The practice has two 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 ‘The Dental Practice - Valley Shopping Village Kingsway’ is one of the principal dentists.

On the day of inspection, we collected 49 CQC comment cards filled in by patients.

During the inspection we spoke with both principal dentists and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Wednesday 8.30am to 6pm

Tuesday 8.30am to 4.30pm

Thursday 8.30am to 5.30pm

Friday 8am to 3pm.

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 apart from a child’s oxygen mask which was ordered immediately on the inspection day.
• The practice had systems to help them manage risk to patients and staff. A review of their systems for risk management in relation to radiation protection, clinical waste storage and lone working was needed.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures. The processes for obtaining Disclosure and Barring Service (DBS) checks prior to employment should be reviewed.
• 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 practice's recruitment procedures to ensure that appropriate DBS checks are completed, or risk assessments are in place to mitigate the risk of not undertaking a check, for staff commencing employment at the practice.
• Review the practice's waste storage protocols to ensure waste is stored securely in compliance with the relevant regulations, and taking into account the guidance issued in the Health Technical Memorandum 07-01.
• Review the practice's protocols for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment. In particular, review the installation and critical examination documentation for the X-ray units.
• Review the practice's lone worker’s policy to ensure risk assessments are undertaken for staff who work alone.

People were given appropriate information about the service and the treatment they received. We spoke with three people who used the service who told us they understood the treatment choices available to them. One person told us, "The dentist I go to see is very clear. He explains things in a way which I understand, asks if I have any questions, and always checks which treatment I want to go for. He’s very good." Another person said, "I like this practice, I’ve been going a long time, and I’ve recommended it to a few people too. I used to be quite nervous, but the dentist is very calm and puts me at ease."

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People told us they were happy with the care and treatments they had received. One person said, “I’ve never been anything less than satisfied. I can get an appointment usually within the week, I’m seen on time, and I’ve never had issues with my treatment. I can’t ask for more really.” Another person said, “I’ve been going there for a long time now and always been happy with my treatment.”

Staff training was kept up to date so that staff could care for people safely and to an appropriate standard. We found people were protected from the risk of infection because appropriate guidance had been followed and there was an effective system in place to monitor and assess the quality of the service.