We carried out an announced comprehensive inspection on 20 March 2017 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

Background

Mydentist, Eastgate Street, Gloucester is a dental practice providing mainly NHS treatment for both adults and children.

The practice is situated on the second floor of Eastgate House, a large accessible building shared with a number of other services including an NHS health access centre. There is lift access to the service from the ground floor. Some on street parking is available in Eastgate Street and there are local car parks as well as local bus and train links.

There are 10 surgeries in the practice and two rooms for the processing and sterilisation of instruments. There is one central reception area with five surgeries and a spacious waiting area on each side of the reception. All areas are wheelchair accessible.

The practice employs nine dentists, two dental hygienists, six dental nurses, 6 trainee dental nurses, six reception staff and a treatment coordinator.

The practice opens: Monday 9am – 5.30pm, Tuesday 9am – 7pm, Wednesday 9am – 5.30pm, Thursday 9am – 7pm, Friday 9am – 5.30pm, Saturday: Closed, Sunday: Closed.

There are arrangements in place to ensure patients receive urgent dental assistance when the practice is closed. If patients called the practice when it was closed, an answerphone message gives the telephone number patients should ring.

The practice manager is also 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.

Before the inspection, we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from 38 patients. In addition we spoke with two patients on the day of our inspection. Feedback from patients was positive about the quality of care, the caring nature of all staff and the overall high quality of customer care. They commented that staff put them at ease and listened to their concerns. They also reported they felt proposed treatments were fully explained them so they could make an informed decision which gave them confidence in the care provided.

Our key findings were:

• We found that the practice ethos was to provide patient centred dental care in a relaxed and friendly environment.
• Effective leadership was provided by an empowered practice manager.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment was readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Infection control procedures were effective and the practice followed published guidance.
• The practice had effective processes in place for safeguarding adults and children living in vulnerable circumstances.
• There was a policy and procedure in place for recording adverse incidents and accidents.
• The dentists provided dental care in accordance with current professional and National Institute for Care Excellence (NICE) guidelines.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Patients could access treatment and urgent and emergency care when required.
• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD) by the practice manager and provider.
• Staff we spoke with felt well supported by the principal dentists and were committed to providing a quality service to their patients.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting.

We spoke with four people who used the practice. They made positive comments about the practice and the treatment they had received. One person told us, "I'm very pleased with all the treatment I have received here". People also told us that the staff were polite and respectful to them. We found that people were able to give their views about the service they had received. People told us how they had their dental treatment explained to them and records that we looked at showed this. Staff had received training to protect children and vulnerable adults from the risk of abuse. Everyone we spoke to said that the practice environment was clean when they visited. We found that there were effective procedures in use for the decontamination of dental instruments. We also found that quality monitoring systems were in place that included seeking the views of people using the service.