We carried out a follow-up inspection at Villa Dental Suite Ltd on 6 October 2017.

We had undertaken an announced comprehensive inspection of this service on 27 February 2017 as part of our regulatory functions where a breach of legal requirements was found.

After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach. This report only covers our findings in relation to those requirements. We checked whether they had followed their action plan to confirm that they now met the legal requirements.

We reviewed the practice against one of the five questions we ask about services: are the services well led? You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Villa Dental Suite Ltd on our website at www.cqc.org.uk.

We revisited Villa Dental Suite Ltd as part of this review and checked whether they now met the legal requirements. We carried out this announced inspection on 6 October 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.

• Is it well-led?

This question forms the framework for the areas we look at during the inspection.

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Villa Dental Suite Ltd is in Bingley and provides private treatments to adults and children. Treatments include dental implants and conscious sedation.

There is level access for people who use wheelchairs and pushchairs. The practice has a dedicated car park for patients.

The dental team includes three dentists, four dental nurses, one dental hygienist, one receptionist and a practice manager. The practice has four 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 Villa Dental Suite Ltd was the practice manager.

During the inspection we spoke with one dental nurse 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 to Friday from 9:00am to 6:00pm

Saturday from 9:00am to 12:30pm

Our key findings were:

• Medicines were now stored securely.
• Decontamination and infection control procedures had been reviewed and now followed nationally recognised guidance.
• An infection prevention and control audit had been carried out.
• The practice had reviewed staff recruitment procedures. All staff now had Disclosure and Barring Service (DBS) checks.

We found the provider had taken action to ensure all staff were provided with appropriate training and support to allow them to undertake their role.

We did not speak to any people that used the service during this follow up visit.

During the inspection we had the opportunity to speak with two people who used the service. They told us they were satisfied with the care and treatment provided.

Their comments included: “the dentist explained everything regarding my plan of treatment, gave me a printed treatment plan and information on the effects of treatment” and “The dentist is very professional, I can’t fault the place.”

We found the provider had appropriate systems in place to ensure consent was gained before they proceeded with examination or treatment.

We found the provider had taken steps which ensured the care and welfare of people who used the service. There were arrangements in place to deal with medical emergencies.

We found the provider operated in clean and tidy facilities and had suitable infection prevention and control protocols in place.

However we found the provider did not have appropriate arrangements in place to ensure staff were receiving suitable training.

We saw evidence there was an appropriate system in place for listening to and acting on people’s comments and concerns.

We carried out an announced comprehensive inspection on 27 February 2017 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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 not providing well-led care in accordance with the relevant regulations.

Background

Villa Dental suite offers a range of dental treatments, including preventative, restorative and cosmetic treatments, including dental implants for private patients.

The staff consists of two dentists, one dental hygienist, four dental nurses, a practice manager (who is the registered manager) and a receptionist.

The practice is in a converted building close to the town centre of Bingley in West Yorkshire.

There are four treatment rooms, a decontamination room, office and a large waiting/ reception area. There is a car park available at the practice. The opening hours are Monday – Friday 9am-6pm, with Saturday opening 9am-12:30pm.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The premises were visibly clean and tidy but the practice did not always follow infection control guidelines.
• Staffing levels were good and effective training was in place, but we found recruitment procedures were not effective.
• We found that not all medicines were secure.
• Decontamination and Infection control procedures did not comply with relevant guidelines.

We identified regulations that were not being met and the provider must:

• Ensure the practice’s protocols for medicines management and ensure all medicines are stored safely and securely.
• Ensure the practice’s decontamination procedures and protocols are effective giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• Ensure the validation procedures of all decontamination processes and implement logs to record the process.
• Ensure the practice's recruitment policy and procedures are suitable and the recruitment arrangements are in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.