We carried out a focused inspection of Market Place Dental Care on 6 July 2018.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Market Place Dental Care on 25 January 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions where we found the registered provider was not providing well-led care in accordance with Regulation 17 ‘good governance’ of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Market Place Dental Care on our website www.cqc.org.uk.

When one or more of the five questions is not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

We undertook a follow up focused inspection of Market Place Dental Care on 6 July 2018. This inspection was carried out to review in detail the actions taken by the practice to improve the quality of care and to confirm that the practice was now meeting legal requirements.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Market Lane Dental Care is in Selby and provides NHS and private treatment to adults and children.

The dental practice is located on the first floor and is not accessible to wheelchair users. The practice would signpost any patients who could not access the premises to accessible local services due to this.

The dental team includes two dentists, four dental nurses (one of whom was a trainee), a dental hygiene therapist, a receptionist and a practice manager.

The practice is owned by a partnership 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 Market Lane Dental Care was the principal dentist.

During the inspection we spoke with the dentist, practice manager and two dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday from 9:30am to 5pm

Our key findings were:

• Improvements to systems and processes to ensure good governance in accordance with the fundamental standards of care had been made. This was in the areas of staff recruitment records, risk assessments and audits.

• Improvements had been made to the arrangements for receiving and responding to patient safety alerts recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).

We carried out this announced inspection on 25 January 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. We did not receive any information of concern from them.

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 not providing well-led care in accordance with the relevant regulations.

Background

Market Lane Dental Care is in Selby and provides NHS and private treatment to adults and children.

The dental practice was located on the first floor and was not accessible to wheelchair users. The practice would signpost any patients who could not access the premises to accessible local services due to this.

The dental team includes two dentists, four dental nurses (one of whom was a trainee), a dental hygiene therapist, a receptionist and a newly appointed practice manager.

The practice is owned by a partnership 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 Market Lane Dental Care was the principal dentist.

On the day of inspection we collected six CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses, the receptionist 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 – Friday 9:45 am – 5pm

The practice is closed for lunch from 1pm – 1:45pm.

Our key findings were:

• The practice was clean and well maintained.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 practice had infection control procedures which were inconsistent.
• The practice had limited systems to help them manage risk.
• The practice did not have thorough staff recruitment procedures.
• The appointment system did not always meet patients’ needs.
• The practice did not have effective leadership.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider was not meeting are at the end of this report.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).
• Review availability of an interpreter services for patients who do not speak English as a first language.

Surveys completed by people who received treatment at the surgery were positive about the service provided. People said they were given enough information about their treatment options and the relevant fees and were able to ask all the questions they wanted to.

They found the staff friendly and said they were treated with respect and their privacy was maintained.