We carried out this announced inspection on 1 March 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.

We told the NHS England Cheshire and Merseyside area team 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 Newtown Dental Centre is close to the centre of St Helens and provides dental care and treatment to adults and children on an NHS and privately funded basis.

There is one step at the front entrance to the practice. The practice has three treatment rooms. Car parking is available near the practice.

The dental team includes a principal dentist, four associate dentists, six dental nurses, three of whom are trainees, and one of whom also carries out reception duties. The team is supported by a practice manager and an assistant practice manager.

The practice is owned by a company and as a condition of registration must have in place a person registered with the Care Quality Commission as the registered manager. Registered managers have a 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 Newtown Dental Centre is the practice manager.

We received feedback from 18 people during the inspection about the services provided. The feedback provided was positive about the practice.

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

The practice is open:

Monday to Friday 8.30am to 5.00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures in place which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medical emergency medicines and equipment were available.
• The practice had systems in place to help them manage risk.
• The practice had safeguarding processes in place and staff knew their responsibilities for safeguarding adults and children.
• Staff provided patients’ care and treatment in line with current guidelines.
• The practice had a procedure in place for dealing with complaints.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system took patients’ needs into account. Dedicated emergency appointments were available.
• The practice had a leadership structure. Staff felt involved and supported and worked well as a team.
• The practice asked patients and staff for feedback about the services they provided.
• The practice had staff recruitment procedures in place. We found that not all the required information was available.

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

• Review the practice’s arrangements for staff to raise concerns at work and ensure details of external organisations, for example, Public Concern at Work, are available.
• Review the practice's recruitment procedures to ensure they are in accordance with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and ensure the necessary pre-employment checks are carried out for staff and the required specified information in respect of persons employed by the practice is held.
• Review the security of NHS prescription pads in the practice to ensure they are all securely stored.
• Review the practice’s audit protocols to ensure audits have documented learning points and action plans where appropriate.

We spoke with four patients who had received treatment at the practice on the day of our inspection. They told us they were satisfied with the dental treatment they had received.

They said the dentist treated them with respect. One patient said “I feel at ease with this dentist.”

All the patients we spoke with said it was easy to get an appointment. One patient told us "The practice gives you confidence in the dental procedures. It has a relaxed atmosphere."

Patients told us the dentists clearly communicated to them what their treatment options were including any potential side effects. Details about charges were provided before any decisions on treatment were made. This meant that patients were able to make informed decisions about which treatment option was best for them.

The practice had undertaken an audit of HTM 01-05 in September 2013 and a score of 98% was achieved. This demonstrated that the practice had taken steps to ensure it was compliant with this guidance.

We looked at the systems and processes the practice had in place to continuously monitor the quality of service being provided. We found there was systems in place for gathering, recording and evaluating information about the service to ensure patients received safe effective care, support and treatment. This meant the practice had undertaken work to quality assure the services they provided