We carried out this announced inspection on 5 April 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.

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

This Mydentist dental practice is in Skegness and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including spaces for blue badge holders, are available near the practice.

The dental team includes three dentists, one dental hygiene therapist, three dental qualified nurses, two trainee dental nurses, two receptionists and a practice manager. The practice has four treatment rooms, one of which is situated on the ground floor.

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 Ida Road, Skegness is the practice manager.

On the day of inspection we collected 18 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with two dentists, two dental nurses, 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 to Friday: 9am to 5pm; plus 9am to 5pm on an occasional Saturday.

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 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• 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. 
• The practice had suitable information governance arrangements.

This inspection was carried out to see if improvements had been made following our inspection of 24 January 2013.

During this inspection, we spoke with the registered manager and the regional compliance manager. We did not speak with patients using the service.

We found the provider had an effective system to regularly assess and monitor the quality of service that patients received. The provider had a system in place to check the written records matched with the computer records. We saw evidence of regular audits relating to the prescribing of medication and record keeping. The provider recorded all accidents and incidents and has a system in place to learn from such occurrences.

During our inspection we spoke with five members of staff and six patients who used the service as well as the registered manager.

The patients we spoke with were positive about the way staff treated them and the care they received. They told us the dentists involved them in their care and they could make choices about the treatment they received.

Patients consented to treatment and were told about the cost before it was undertaken. Patients felt the care they received was good.

We saw staff changed out of their uniforms to take their lunch breaks. There were robust systems in place to reduce the risk of infection. One patient told us, “They’re always changing their gloves.”

Patients told us they had confidence in the staff. Staff were supported to give care that was of a good quality. A dental nurse told us she had been given the opportunity to undertake further advanced training.

Patients were asked for their views and comments about the service. We found there were not always systems in place to make sure risks to patients safety were identified and managed effectively.