We carried out this announced inspection on 5 April 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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 Hill Top Dental Practice is in Knottingley and provides NHS and private treatment to adults and children.

There is a small step to enter the premises but there is a mobile ramp for those who need it. Car parking spaces are available across the road in front of a row of shops.

The dental team includes four dentists, four dental nurses (one is a trainee), two receptionists, a group practice manager, a compliance/dental nursing co-ordinator and a reception co-ordinator/personal assistant. The practice has three treatment rooms.

The practice is owned by an individual who is the practice owner. 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 received feedback from 21 patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, two dental nurses, two receptionists, the group practice manager, the compliance/dental nursing co-ordinator, the reception co-ordinator/Personal assistant and the registered provider. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday from 9:00am to 6:00pm

Friday 9:00am to 5:00pm

They are closed for lunch Monday to Friday from 1:00pm to 2:00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff had received annual training in cardiopulmonary resuscitation (CPR) but not medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had 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 a staff recruitment procedure. This was not always followed.
• 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 patients for feedback about the services they provided.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result.
• Review staff training to manage medical emergencies giving due regard to guidelines issued by the General Dental Council (GDC) standards for the dental team.
• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.
• Review the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely.
• Review the storage of dental care records to ensure they are stored securely.
• Review the practice's recruitment procedures to ensure Disclosure and Barring Service (DBS) checks for new staff are sought at the point of employment.
• Review its complaint handling procedures and ensure verbal complaints which have not been dealt with within 24 hours receive a written response.
• Review the practice’s responsibilities to meet the needs of people with a disability and the requirements of the equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.