We carried out an announced comprehensive inspection of this practice on 5 November 2015. Breaches of legal requirements were found.

We undertook this focused inspection to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Midland Road Dental Surgery on our website at www.cqc.org.uk

Our findings were:

Are services well-led?

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

Background

Midland Road Dental Practice is a general dental practice situated in a converted house in the centre of Bedford. The practice offers mostly NHS and some private treatment to adults and children.

The premises consist of a reception area and waiting room on the ground floor, and two treatment rooms along with a dedicated decontamination room on the first floor.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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.

Our key findings were:

• The practice was maintaining accurate, complete and contemporaneous records in respect of each patient.

• Risk assessments had been carried out to identify and assess areas of risk to the health and safety of staff, patients and visitors to the practice.

• Clinical audit had been used effectively to highlight areas of concern within clinical practice.

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

• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.

We carried out an announced comprehensive inspection on 5 November 2015 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 not providing well-led care in accordance with the relevant regulations.

Midland Road Dental Practice is a general dental practice in central Bedford offering NHS and private dental treatment to adults and children.

The premises consist of a reception area and waiting room on the ground floor and two treatment rooms on the first floor. There is also a separate decontamination room.

The staff team at the practice consists of a principal dentist (who is also the registered manager), an associate dentist, a dental nurse, a trainee dental nurse and three part time receptionists.

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.

Our key findings were:

• There were effective systems in place to reduce the risk and spread of infection. We found the treatment rooms and equipment were visibly clean.

• There were systems in place to check equipment had been serviced regularly, including the dental air compressor, autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.

• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.

• The practice promoted good oral and general health. This included the promotion of local smoking cessation services.

• Staff demonstrated their knowledge of the practice’s whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were kind, caring and welcoming which put patients at their ease.

• We received feedback from 50 patients. Common themes were patients felt they received excellent personalised service from a caring, efficient and friendly practice team.

• There was an effective system in place to act on feedback received from patients and staff.

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We identified regulations that were not being met and the provider must:

• Establish an effective system to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors.

• Maintain an accurate, complete and contemporaneous record in respect of each patient, including a record of the care and treatment provided to the patient and of decisions taken in relation to the care and treatment provided.

• Ensure audits of various aspects of the service, such as radiography and dental care records are undertaken at regular intervals to help improve the quality of the service. The audits must include documented learning points and the resulting actions taken to ensure that improvements are completed.

You can see full details of the regulations not being met at the end of this report.

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

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

• Review the practice protocols for monitoring the availability of emergency medicines.

During our visit to this practice on 29 August 2012 we spoke with three waiting for treatment. They all told us that the dentist and the staff team treated them politely and involved them in their treatment plan. People also told us that they were able to discuss any treatments or medical conditions they had with the dentist in the privacy of the dentist's surgery. One person said, “Miss Ampah always seems to have time to explain things, even though she is so busy”.

People told us that they were regularly asked to complete a document about any medical conditions they had and that they were asked to update this information at each visit. One person said, “I feel confident that she (Miss Ampah) understands my medical condition and considers my medication when giving me treatment. That’s why I keep coming back.” Another person told us that the daily emergency appointment time meant that they knew they would always be seen if they had a problem.

All of the people that we spoke with commented on the upgrades that had been made to the décor of the surgery.

During our visit to the practice on 12 and 16 January 2012 we spoke to seven people waiting for treatment. They told us that the staff team treated them politely and involved them in their treatment plan. One person said, “I have been seeing her (the dentist) regularly for the last six years. She gives me confidence, she always tells me what she is doing and explains what she could do for me”. People we spoke with were aware of their treatment plans and told us that they were asked to sign them. They told us that they were happy with the care and the treatment that they received and that the dentist always spoke to them about their general health and checked their mouth as well as their teeth. One person said, “I call it an MOT for my mouth, coming here”. Another person told us that the dentist always wore gloves and glasses when providing treatment.