The Dental Team

We carried out this announced inspection on 3 July 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

The Dental Team is in Stretford, Manchester, and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. On street parking is available near the practice.

The dental team includes five dentists, five dental nurses (four of whom are trainees), a dental hygienist, a practice manager and a receptionist. The practice also has access to a compliance lead who provides support to three dental practices. 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 The Dental Team is the principal dentist.

On the day of inspection, we collected 44 CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, dental nurses, the dental hygienist 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 9am to 1pm and 2pm to 8pm

Tuesday and Wednesday 9am to 1pm and 2pm to 6pm

Thursday 9am to 1pm and 2pm to 5.30pm

Friday 9am to 3pm

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance. Decontamination processes should be reviewed.
• Staff knew how to deal with emergencies. Appropriate medicines were available. The service did not have an automated external defibrillator (AED). One was obtained immediately after the inspection.
• The practice had systems to help them identify and manage risk to patients. Fire risks could be better assessed.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had thorough staff recruitment procedures except for disclosure and barring service (DBS) checks and evidence of immunity.
• 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 provided preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• 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 fire safety risk assessment to ensure that any actions required are complete and ongoing fire safety management is effective.

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice. In particular, DBS checks and evidence of immunity.

• 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’. In particular, processes to decontaminate and inspect instruments before sterilisation.

• Review the security of NHS prescription pads in the practice, ensuring prescriptions are not pre-stamped with the practice name and address.

• Review the practice’s protocols to ensure audits of radiography and infection prevention are completed effectively to improve the quality of the service. The practice should ensure that where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.