We carried out this unannounced inspection on 28 September 2017 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 second CQC inspector and a specialist dental adviser.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not have any relevant information to share with us regarding this dental practice.

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

Mint Dental Care is located in Skegness in Lincolnshire. The practice provides only private dental treatments to patients of all ages.

The practice is located on two floors with all patient areas located on the ground floor. There is level access into the practice and the treatment rooms. There are two treatment rooms both of which are located on the ground floor. There is a pay and display car park opposite the practice.

The dental team includes three dentists; one part-time dental hygienist; two qualified dental nurses and two trainee dental nurses.

The practice is owned by an organisation 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 practice was the principal dentist.

On the day of inspection we collected six CQC comment cards filled in by patients. We also spoke with one patient during the inspection. This information gave us a positive view of the practice.

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

The practice opening hours are: Monday: 8:30 am to 5:30 pm; Tuesday: 8:30 am to 5:30 pm; Wednesday: 10:30 am to 7:30 pm; Thursday: 8:30 am to 5:30 pm; Friday: 8:30 am to 2 pm and Saturday by appointment only

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which mostly followed published guidance.
• The washer disinfector was overdue for its annual service.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and knew their responsibilities for safeguarding adults and children.
• The practice did not have all of the documentation required by schedule 3 or their own staff recruitment procedures.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took measures to protect their privacy and personal information.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice did not have an induction hearing loop
• The audit system was not effective due to the frequency, depth and scope of audits needing to be reviewed.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice dealt with complaints positively and efficiently.

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

• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.

• Review the practice’s servicing protocols for equipment used for cleaning used dental instruments taking into account guidelines issued by the Department of Health - 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.

• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010. 
• Review the practice's current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.