We carried out this announced inspection on 15 August 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.

We told the NHS England area team that we were inspecting the practice. They provided information which we took into account.

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 – Avonmouth Road - Avonmouth provides NHS and private treatment to patients of all ages.

There is level access for patients who use wheelchairs and pushchairs. There are no car parking spaces available. There is onstreet parking and local transport services available.

The dental team includes two dentists, one trained dental nurses, one trainee dental nurses and two receptionists. The practice has three treatment rooms.

The practice is owned by a 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 – Avonmouth Road - Avonmouth was the practice manager.

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

During the inspection we spoke with two dentists, two dental nurses, one receptionist, the practice manager, the area manager and the regulatory officer for the organisation. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Friday 8:30am to 6:30pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• 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 had staff recruitment procedures, which should be improved upon.
• 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 positively and efficiently.

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

• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the protocol for completing accurate, complete and detailed records relating to employment of staff. This includes ensuring references have been sourced following company policy, and risk assessments completed when Disclosure and Barring Service checks had not been returned prior to employment.
• Review the practice’s infection control procedures and protocols to ensure infection control audits are completed on a six monthly basis giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review how patient survey results are monitored to ensure patient feedback was captured and acted upon effectively.

People that we spoke with on the day of our visit told us that treatment options were explained and that they were aware of the costs that would be incurred. We were told that staff were friendly and welcoming and that appointments were easy to make. People confirmed that their medical histories were taken prior to treatment being commenced. One person told us that their daughter had been seen by a dentist at the practice and was happy with how the treatment had gone.

We also looked at patient feedback gathered through surveys and comment forms and noted a number of positive comments. These included 'many thanks for a friendly relaxing experience', and 'very friendly and put's people at ease'.