We carried out an announced comprehensive inspection on 15 March 2016 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

Mydentist Bramcote is situated on two floors of a building to the west of Nottingham city centre. The practice was registered with the Care Quality Commission (CQC) in May 2011. The practice provides mostly NHS dental treatment (70%). Services provided include general dentistry, dental hygiene, crowns and bridges, and root canal treatment.

The practice’s opening hours are: Monday: 9 am to 5:30 pm; Tuesday: 9 am to 8 pm; Wednesday, Thursday and Friday: 9 am to 5:30 pm. The practice is closed at the weekends.

Access for urgent treatment outside of opening hours is by telephoning the practice and following the instructions on the answerphone message. Alternatively patients should ring the 111 telephone number for access to the NHS emergency dental service.

The practice manager 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.

The practice has one oral surgeon; nine dentists; one foundation dentist; one hygienist; one therapists; eight dental nurses; two trainee dental nurses; three receptionists; a practice manager and a treatment co-ordinator.

We received positive feedback from 11 patients about the services provided. This was through CQC comment cards left at the practice prior to the inspection and by speaking with patients in the practice.

Our key findings were:

• Patients spoke positively about their experiences of the dental services they received, and said they were treated with dignity and respect.
• Dentists identified the treatment options, and explored and discussed these with patients. However they were not always fully recorded in patients’ notes.
• Patients’ confidentiality was maintained.
• There were systems in place to record accidents, significant events and complaints, and where learning points were identified these were shared with staff.
• The records showed that apologies had been given for any concerns or upset that patients had experienced at the practice.
• There was a whistleblowing policy and procedures and staff were aware of these procedures and how to use them. All staff had access to the whistleblowing policy.
• Records showed there were sufficient numbers of suitably qualified staff to meet the needs of patients.
• The practice had the necessary equipment for staff to deal with medical emergencies, and staff had been trained how to use that equipment including oxygen and emergency medicines.
• The practice followed the relevant guidance from the Department of Health's: ‘Health Technical Memorandum 01-05 (HTM 01-05) for infection control.
• Dentists involved patients in discussions about the care and treatment on offer at the practice.
• Patient recall intervals were in line with National Institute for Health and Care Excellence (NICE) guidance.

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

• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray giving due regard to the Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) 2000.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review its responsibilities to the needs of people with a disability and the requirements of the equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.
• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. Practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.

We spoke with three people using the service. All were extremely satisfied with the treatment provided. Two people said they had received better treatment there than anywhere else. One person said of the dentist: “Brilliant. Can’t fault him.”, but was less satisfied with waiting times and cancellations. Everyone we spoke with said they had to wait for an appointment.

Two of the people we spoke with were anxious about visiting a dentist. One told us: "I hate coming to the dentist. I don’t think there’s anything they can do. This one puts me more at ease than any others."

Everyone we spoke with said they thought the service was clean.

All three told us that practitioners wore gloves during examinations and treatment. People who had received treatment told us they had been asked to wear protective equipment to protect them from infection.