We carried out this announced inspection on 22 January 2019 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

Wolstanton Dental Practice is in Newcastle-under-Lyme and provides predominantly NHS treatment alongside private treatment to adults and children.

There are two steps providing access into the building. The practice informs all new patients wanting to register that they are not wheelchair accessible and signpost patients that cannot manage the steps, to a nearby practice. There is a free shopping centre car park opposite the practice which also has spaces available for blue badge holders.

The dental team includes three dentists, four dental nurses, two trainee dental nurses, one dental hygiene therapist, one receptionist, a practice manager and a senior manager. Both managers are qualified dental nurses. The practice has four treatment rooms one is currently out of use.

The practice is owned by an organisation 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 Wolstanton Dental Practice is the senior manager.

On the day of inspection, we collected four CQC comment cards filled in by patients and one letter received from a patient.

During the inspection we spoke with two dentists, one dental hygiene therapist, one trainee dental nurse, the practice manager and the senior manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday: from 9am to 5.30pm

Wednesday and Thursday: from 9am to 5pm

Friday: from 9am to 4.30pm

Saturday: by appointment only.

Our key findings were:

• Effective leadership was provided by the principal dentist and an empowered senior manager.
• Staff felt well supported by the principal dentist and senior manager and were committed to providing a high-quality service to their patients.
• The practice appeared clean and well maintained.
• The provider 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 to patients and staff. The provider regularly completed health and safety audits to identify and mitigate any risk.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. The safeguarding lead was trained to level three in child safeguarding and kept a log of any safeguarding referrals.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs. Patients could access treatment and urgent and emergency care when required.
• The provider had effective leadership and culture of continuous improvement.
• The provider asked staff and patients for feedback about the services they provided. Results of satisfaction surveys were displayed in the waiting room and improvements were made following patient feedback.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the practice’s sharps procedures to ensure the practice is in compliance with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.