We carried out this announced inspection on 14 August 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 Village Dentists is in Cramlington and provides private treatment to adults and children.

There are steps in front of the practice and a portable ramp is available for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice and blue-badge holders can park in front of the premises for three hours. Patients are made aware of this in the practice leaflet.

The dental team includes two principal dentists, a practice manager, an associate dentist, three dental nurses who also perform reception duties, a dental therapist and a dental hygienist. The practice has two treatment rooms.

The practice is owned by a company 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 Village Dentists was the practice manager.

On the day of inspection, we collected 19 CQC comment cards filled in by patients.

During the inspection we spoke with one dentist, three dental nurses, the practice manager and the dental therapist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday 8.30am to 5.30pmTuesday 8.30am to 7pm

Wednesday 8.30am to 5.30pmThursday 8.30am to 7pmFriday 8.30am to 5pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which did not fully reflect published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available -apart from a child air bag and mask and portable suction. One medicine was incorrectly stored and, as a result, had expired.
• The practice had some systems to help them manage risks. Risk assessments were not undertaken for all hazardous substances held on-site.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Training in safeguarding was not consistent amongst staff.
• The practice had staff recruitment procedures. These required reviewing to ensure consistency.
• 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 and culture of continuous improvement.
• 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 practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.
• Audits were undertaken in clinical and non-clinical areas; we noted results were not analysed nor were conclusions drawn from the results, where appropriate.

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

• Review the practice's recruitment policy and procedures to ensure these are consistent for all staff.
• Review the practice's policy for hazardous substances identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken.
• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.
• Review the practice’s protocols to ensure audits have documented learning points and the resulting improvements can be demonstrated.