We carried out an announced comprehensive inspection on 24 January 2017 to ask the practice the following key questions; are services safe, effective, caring, responsive and well-led?

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 Dentist Wilmslow is located in the centre of Wilmslow and comprises a reception and waiting room, a treatment room, a decontamination room and staff rooms all at ground floor level. Parking is available in nearby car parks. The practice is accessible to patients with disabilities, limited mobility, and to wheelchair users. The provider has been providing services at this location since December 2013.

There are patient toilet facilities available in the practice.

The practice provides general dental treatment to patients on a privately funded basis. The opening times are Monday, Wednesday and Friday 9.00am to 4.30pm, Tuesday and Thursday 10.00am to 7.00pm, and Saturday 9.30am to 3.30pm. The practice is staffed by a principal dentist, a practice manager and two dental nurses. A visiting dentist also provides a sedation service for patients who are anxious or undergoing lengthy procedures.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

We received feedback from 14 people during the inspection about the services provided. Patients commented that they found the practice and treatment to be excellent, and that staff were professional, friendly, and caring. They said that they were always given good and helpful explanations about dental treatment, and that the dentist listened to them. Patients commented that the practice was clean and comfortable.

Our key findings were:

• The practice had procedures in place to record and analyse significant events and incidents.
• There were sufficient numbers of suitably qualified and skilled staff to meet the needs of patients.
• The premises and equipment were clean, secure and well maintained.
• Staff followed current infection control guidelines for decontaminating and sterilising equipment.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect, and their confidentiality was maintained.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients.
• The practice gathered the views of patients and took their views into account.
• Staff were supervised, felt involved, and worked as a team.
• Governance arrangements were in place for the smooth running of the practice, and for the delivery of high quality person centred care.
• Staff had received safeguarding training, and knew the processes to follow to raise concerns. We were unable to determine whether two of the staff had been trained to the appropriate level.
• Staff had been trained to deal with medical emergencies, and most emergency medicines and equipment were available.

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

• 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 and through the Central Alerting System as well as from other relevant bodies such as, Public Health England.
• Review the availability and checking of medicines and equipment to manage medical emergencies having due regard to guidelines issued by the Resuscitation Council UK and the General Dental Council standards for the dental team.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance, specifically in relation to the sterilisation of handpieces, and the implementation of the required actions from the legionella risk assessment, namely the monitoring and recording of water temperatures.
• Review training to ensure that staff who are assisting in conscious sedation have the appropriate training and skills to carry out the role having due regard to current guidelines.
• Review the practice’s safeguarding training ensuring all staff are trained to an appropriate level for their role.
• Review the systems for assessing, monitoring and mitigating the various risks arising from undertaking of the regulated activities, specifically in relation to sharps and immunisation effectiveness.
• Review the storage of paper dental care records to ensure they are stored securely.