We carried out this announced inspection on 17 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 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

TLC Dental Limited is near the centre of Poynton and provides private dental care and treatment for adults and children.

The practice is accessed by a flight of stairs. Car parking is available at the practice.

The dental team includes the principal dentist, three dental nurses, two of whom also carry out reception duties, and a receptionist. The practice has one treatment room.

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 TLC Dental Limited was the principal dentist.

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

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

The practice is open:

Monday, Tuesday, Wednesday, and Friday 9.00am to 5.00pm

Thursday 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 medical emergencies. Appropriate medicines and equipment were available, with the exception of one medical emergency medicine which was not the recommended medicine.
• The provider had systems in place to manage risk.
• The provider had safeguarding procedures in place and staff knew their responsibilities for safeguarding adults and children.
• The provider had staff recruitment procedures in place.
• Staff provided patients’ care and treatment in line with current guidelines. The provider did not fully adhere to the guidelines on domiciliary care when providing dental care for people in care homes and their own homes.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The dental team provided preventive care and supported patients to achieve better oral health.
• The appointment system took account of patients’ needs.
• The provider had a procedure in place for dealing with complaints. The practice dealt with complaints positively and efficiently.
• The practice had a leadership and management structure and a culture of continuous improvement.
• 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 provider had information governance arrangements in place.

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

• Review the availability of medicines, specifically buccal midazolam, in the practice to manage medical emergencies taking into account the guidelines issued by the British National Formulary and the General Dental Council.
• Review the practice’s protocols for domiciliary visits taking into account the 2009 guidelines published by British Society for Disability and Oral Health in the document “Guidelines for the Delivery of a Domiciliary Oral Healthcare Service”.