We carried out this announced inspection on 1 October 2018 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 Harwood Clinic is in Sheffield and provides mostly NHS and some private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking is available near the practice.

The dental team includes two dentists, four dental nurses, a receptionist and two dental hygiene therapists. The practice is supported by a practice manager. The practice has two treatment rooms. The principal dentist is registered with the General Dental Council as an Oral Surgery Specialist and is also registered with the General Medical Council.

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 collected 49 CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentist, three 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 – Thursday 9am to 7pm

Friday 9am - 5pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control protocols and procedures in place.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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 provider was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• There was no process in place to test and quality assure the dental Cone Beam (Computed Tomography) (CBCT) machine.
• 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 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 and procedures 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 HPA-CRCE-010 Guidance on the Safe Use of Dental Cone Beam (Computed Tomography). In particular: Quality assurance processes and routine monthly testing.

We spoke privately with six people who were attending the practice for check ups or treatment. All six people told us that they were "extremely happy" with all aspects of the service. They told us that staff were "very friendly and professional." One person said, "I've recently moved away from this area but I will continue to come here as it's the best." Another person said, "all the staff are very approachable and I have never needed to complain about anything."

All six people that we spoke with said that they felt safe in the care of the dentists. They said that all members of the staff team acted in a professional manner. One person said, "the dentist is good at explaining my treatment to me. I've always hated coming to the dentist and the dentist knows this and treats me appropriately because of my fear."

Everyone commented on the cleanliness of the practice. People said they regularly saw staff making sure that the surgery was clean, tidy and hygienic. We found people received care and treatment in a clean environment with infection control measures in place to minimise the risk of infection.

Staff that we spoke with said they were very well supported by the registered provider to carry out their role. Staff said they were up to date with all mandatory training and we saw confirmation of this.

The provider had an appropriate system in place for gathering, recording and evaluating information about the quality and safety of care the service provided.