We carried out this announced inspection on 10 January 2018 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 - Filton Road - Horfield is in Bristol 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 for patients with disabled badges, are available near the practice.

The dental team includes nine dentists, one lead dental nurse, four trainee dental nurses, one dental hygiene therapist, one head receptionist, three receptionists, two cleaners, one area manager and the practice manager/dental nurse. The practice has nine 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 - Filton Road - Horfield at the time of the inspection the practice did not have a registered manager in post.

On the day of inspection we collected 14 CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.

During the inspection we spoke with eight dentists, one lead dental nurse, four trainee dental nurses, one dental hygiene therapist, one head receptionist, two receptionists, one area manager, two regulatory officers and the practice manager/dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: 08:15 to 5:15 Monday to Friday with other opening times by prior arrangement.

Our key findings were:

• The practice was 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 thorough staff recruitment procedures.
• 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 the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice’s infection control procedures and protocols to take into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and have regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
• Review the current performance review systems in place and have an effective process established for the on-going assessment and supervision of all staff.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

Our visit was discussed and arranged with the practice in advance. This was to ensure that we had time to see and speak to staff who worked at the practice, as well as people registered with the practice.

People told us they were satisfied with the care and treatment provided at Monks Park Dental Centre. One person said, "I have been with my dentist for over five years “I am happy “they make me feel so comfortable" and another person commented, "They have been brilliant, fantastic . Everything is explained well before treatment. I have no problems".

People spoken with confirmed they knew of their treatment plan. They said the dentist had discussed various treatment options with them. People also told us they were treated with respect. They said their questions were answered in a sensitive and professional manner.

Staff had an understanding of safeguarding children and vulnerable adult’s procedures. They knew who to contact in the event of a concern. We saw that staff had received appropriate training tailored to their role.

People received their treatment in a clean environment. We saw that arrangements were in place for the safe decontamination of reusable instruments and equipment to prevent the risk of infection.

There were systems in place to monitor how the practice was run to ensure people received a quality service.