We carried out this announced inspection on 15 May 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 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

Genix Healthcare Dental Clinic is located in Leicester city centre and provides mainly NHS treatment to adults and children. The clinic also offers some private treatments. At the time of our inspection, the practice were accepting new NHS patient registrations for children only.

There is level access for people who use wheelchairs and those with pushchairs. The clinic does not have its own car parking facilities, but public car parking, including spaces for blue badge holders, are available near the practice.

The dental team includes two dentists, two dental nurses, (one of whom is a senior nurse) one apprentice dental nurse and a receptionist. One of the dental nurses also undertakes administrative duties. A practice manager is also temporarily working at the clinic providing support until a permanent manager is recruited to the role.

The practice has two treatment rooms, both are on the ground floor.

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 Genix Healthcare Dental Clinic – Leicester is a practice manager who works for Genix Healthcare Limited.

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

During the inspection we spoke with one dentist, two dental nurses, the receptionist, the practice manager and an operations manager who worked for the provider. We looked at practice policies and procedures, patient feedback and other records about how the service is managed.

The practice is open: Monday, Tuesday, Friday from 9am to 5.30pm, Wednesday and Thursday from 8am to 8pm and Saturday from 9am to 2pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 staff 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 we spoke with treated patients with dignity and respect and there were sufficient measures deployed to protect patients’ privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and the staff we spoke with said they worked well as a team. We received some negative feedback from patients and staff. We were told that the provider was taking steps to address issues raised.
• The practice asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the practice’s systems for assessing, monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular: ensure that a five yearly fixed electrical wiring test has been undertaken with satisfactory results, a gas safety certificate is obtained and that emergency lighting testing is undertaken and information recorded and made available to the provider.
• Ensure that good governance and leadership are sustained in the longer term.
• Review the practice’s processes and systems for seeking and learning from patient feedback with a view to monitoring and improving the quality of the service.

We spoke with four patients and observed appointments with a further three. They all told us they were very satisfied with the service. All of the patients we spoke with had had unsatisfactory experiences with previous dental services and thought this service was much better. They all told us they were asked for their consent before dentists provided any treatment. They told us they were given information in a way they understood so they could make an informed decision about whether to accept treatment. We saw that the dentist obtained informed consent from all patients.

We spoke to four patients who were confident they would know what to do if they were unhappy with the way they were treated. We noted that there was no information for patients about safeguarding procedures. During the course of our inspection, managers posted information in the waiting room so patients could see what they should do if they were concerned about abuse of children or vulnerable adults. We found the provider had effective systems for protecting people from abuse.

The patients we spoke with all told us they were confident the dentist provided safe treatment to a good standard. We found that all staff were supported to maintain and improve their practice.

Four people attended for appointments at the service during our inspection. Three agreed to speak with us. They all said they thought the service had been clean every time they visited. One person told us they thought the dental instruments were clean. All three people said that the dentists and dental nurses wore gloves when they were treating them. One person had noticed that the dentist washed their hands before putting on their gloves. This showed that people were protected from the risk of infection because the premises were clean and staff followed effective infection control and prevention procedures.

People were generally satisfied with the service they had received. One person told us they were: "Very pleased." with waiting times. When asked for their general comments about the service, the same person told us: "So far, so good." People told us they were given information in an appropriate format so they could understand and be involved in decisions about treatment.

People told us they were happy with the cleanliness of the service. When asked, they told us that dental practitioners used personal protective equipment, such as disposable gloves.