We carried out this announced inspection on 27 June 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 specialist dental adviser.

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

Mydentist – Archer Road is in Redditch and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces, including some for patients with disabled badges, are available near the practice.

The dental team includes eight dentists, seven dental nurses, three trainee dental nurses, two dental hygienists, a practice manager who is a qualified dental nurse and four receptionists. The practice has five treatment rooms.

The practice is owned by a corporate company 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 Mydentist – Archer Road was the practice manager.

On the day of inspection we collected 10 CQC comment cards filled in by patients and looked at recent survey responses. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, three dental nurses, the regulatory officer, the area development manager, one 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: 8am to 7pm

Tuesday: 8am to 8pm

Wednesday: 8am to 6pm

Thursday: 8am to 7pm

Friday: 8am to 5pm

Saturday: 9am to 4pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance although the practice were unable to locate the infection control audit. A new audit was undertaken on the day of our inspection and an action plan was developed.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice carried out staff recruitment procedures, although two contracts of employment were not on personnel files, these were held centrally and sent to us following the inspection.
• 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 appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints although due to a changeover in management complaints were being dealt with centrally by a patient liaison officer whilst process training was given to the covering practice manager.
• Clinical audit was not effective as a tool to highlight areas of improvement as prescribing, record keeping and radiography audits had been completed in June 2017 and had not been re-audited to provide analysis for improvement and subsequent action plans had not been completed. Previous audits to these could not be located on the day of our inspection.

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

• Review the practice’s waste handling protocols to ensure waste is stored securely in accordance with relevant regulations taking into account guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Review the practice's process for undertaking audits and ensure all identified objectives and recommendations are reviewed during the next audit cycle.

Our inspection was discussed and arranged with the staff at the practice two days in advance. This was to ensure that we had time to see and speak with staff working at the practice, as well as people registered with the practice.

During the inspection we spoke with the practice manager, the regional manager, three dental nurses and one receptionist. We reviewed some dental records, staff files, written policies and procedures and quality audits. After our inspection visit, we spoke by telephone with four people who were registered with the practice.

People that used the practice told us that they received care and treatment that was planned and met their needs.

All consultations were recorded and any change in people’s health needs taken into account when planning any treatment. General health and oral care advice was given as part of the consultation.

People told us that the practice was clean and tidy and that they had no concerns about hygiene.

The planning and delivery of training made sure that the training needs of staff were met.

We saw that there were arrangements in place to monitor the quality and safety of care. This ensured that risks were identified and responded to.