We carried out an announced comprehensive inspection on 23 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 providing well-led care in accordance with the relevant regulations

Background

MK Dental Spa is a predominantly private dental practice situated on the first floor of a purpose built building in the Kiln Farm area of Milton Keynes.

The practice has a range of dental specialists, and operates a referral system whereby other practices can refer their patients for specific specialist treatments, such as endodontics (root canal treatment) periodontics (gum treatment) and dental implants (where a titanium post is placed surgically into the jaw bone. It is then used to replace a tooth, or support a bridge or denture). In addition an oral surgeon with a National Health Service (NHS) contract works two days a week. Patients requiring oral surgery (tooth extractions etc.) can be referred on the NHS.

The practice is open from 8.45 am to 5.30 pm Monday, Tuesday, Thursday and Friday. 8.45 am to 6.30 pm on Wednesday and alternate Saturday mornings by appointment only.

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.

25 patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with patients on the day of the inspection. Overall the information from patients was very positive. Patients were positive about their experience and they commented that they were treated with kindness and respect.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.

• Governance arrangements were in place for the smooth running of the practice; however the practice did not retain information regarding continuous professional training of individual staff. For this reason the registered manager could not be assured that all required training was up to date in accordance with the requirements of the General Dental Council.

• Robust systems were in place to ensure that patients were able to provide valid, informed and educated consent.

• The practice had good systems and adequate training in place for providing conscious sedation to patients (these are techniques in which the use of a drug or medicine or medicines produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation).

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

• Review availability and staff knowledge of equipment and medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), the British National Formulary, and the General Dental Council (GDC) standards for the dental team.

• Review at appropriate intervals the training, learning and development needs of individual staff members and have an effective process established for the on-going assessment and supervision of all staff.

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

We spoke to one person during the visit who said the practice and its staff were very good. We were told sufficient information including written estimates of treatments had been given prior to treatments taking place. The dentist had explained the proposed treatment and had involved him in the decision making regarding the treatments he had received. He said that he had given consent prior to treatments taking place.

The practice and its environment were described as clean.