We carried out this announced inspection on 17 November 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.

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

Wigan Dental Centre is in Whelley and provides private treatment to adults and children. They also provide dental implants, under sedation where appropriate.

The practice is located in converted business premises. The treatment room is located on the first floor of the premises which is not accessible to people who use wheelchairs. On street parking is available near the practice. The dentist also works at a practice nearby; arrangements can be made to see wheelchair users at that location.

The dental team includes a dentist, three dental nurses (one of whom is a trainee and one of whom is also the practice manager), and a dental hygienist. The practice has one treatment room.

The practice is owned by an individual who is the principal dentist there. 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 collected 47 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist, 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 9.00 to 19.00

Tuesday and Thursday 9.00 to 13.00

Wednesday 9.00 to 18.00

Friday 9.00 to 17.00

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with 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 thorough staff recruitment procedures.
• 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 staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.

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

• Review the current legionella risk assessment and ensure the treatment of dental unit waterlines are appropriate taking account of the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Review the storage of products identified under the Control of Substances Hazardous to Health 2002 Regulations to ensure they are kept in appropriately labelled containers.

• Review the availability of an interpreter service for patients who do not speak English as their first language.

We visited Wigan Dental Centre on 20 February 2013.

We found that the combined reception area and waiting room was clean and bright. There was a range of information leaflets and posters with information on treatments and oral hygiene. There was a TV mounted on the wall for entertainment.

We spoke with 3 patients during the inspection, we were told: "Absolutely brilliant dentist, that’s why I come here”, “They make you feel welcome”, and “I have no complaints at all".

Treatments records were maintained both in electronic and paper formats and contained full treatment plans. We saw that at every visit the patient was asked for an update of their medical status and any change in prescribed medications.

We saw that emergency medical equipment was in place. Decontamination processes were seen to be followed and hygiene procedures were adhered to by staff, to minimise the risk of cross infection.

We observed that comments and complaints were taken seriously and discussed at practice meetings and used to inform changes and improvements to the service delivered.