We carried out an announced comprehensive inspection on 16 February 2016 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 providing well-led care in accordance with the relevant regulations.

Background

MAC Dental Centre Ltd is located close to the centre of Macclesfield and comprises a reception and waiting room on the ground floor and a first floor waiting room, five treatment rooms, two of which are situated on the ground floor, a decontamination room, offices, storage and staff rooms. Parking is available to the rear of the practice. The practice is accessible for patients with disabilities at the front and rear entrances.

The practice provides general dental treatment to NHS patients of all ages, and general dental treatment and a range of more complex treatments, for example, dental implants, on a private basis.

The practice is open Monday to Thursday 8.30am to 6.00pm and Friday 8.30am to 5.00pm.

The practice is staffed by five dentists, a business manager, a practice manager, five dental nurses, one of whom is the senior nurse and another three of whom are trainees, a dental therapist and four receptionists.

The principal dentist 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.

Forty people provided feedback on CQC comment cards about the services provided. Every comment was very positive about the staff and the service. Patients commented that the practice was clean, hygienic and modern, and they found the staff friendly, considerate and caring. They had trust in the staff and confidence in the dental treatments, and said that they were always given clear, detailed and understandable explanations about dental treatment. Several patients commented that the dentists put patients at ease, have their patients best interests at heart and listen carefully.

Our key findings were:

• The practice recorded and analysed significant events, incidents and complaints and cascaded learning to staff.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies and emergency medicines and equipment were readily available.
• Premises and equipment were clean, secure and properly maintained.
• Infection control procedures were in place and the practice followed published guidance.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Clinical staff were up to date with their continuing professional development and met the requirements of their professional registration.
• Patient’s care and treatment was planned and delivered in line with evidence-based guidelines, and current practice and legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and delays were kept to a minimum.
• The practice staff felt involved and worked as a team.
• The practice sought feedback from staff and patients about the services they provided.
• Governance arrangements were in place for the smooth running of the practice and the practice had a structured plan in place to audit quality and safety.

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

• Review the practice’s infection control procedures and protocols having due regard to 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, specifically in relation to cleaning equipment.
• Review the practice’s sharps procedures having due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• Review the current legionella risk assessment and implement the required actions giving due regard to 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 practice’s responsibilities in relation to the Control of Substances Hazardous to Health Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.

All patients spoken with praised the service and made positive comments about the cleanliness of the premises and standards of hygiene maintained.

They told us that they were happy with the care and treatment provided. They told us that the staff at the practice treated them with respect and involved them in discussion about their symptoms and treatment options. One person said: “I am very happy with them; they are very professional and very good at explaining things. We have discussed what was required, what was recommended, costs and they gave me options”. Another patient said: “I was very nervous but the dentist put me at my ease, he explained everything including costs, treatments and options and gave me a printed treatment plan so I know how he intends to solve my problems.”