We carried out this announced, focussed follow-up inspection on 2 July 2018.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We carried out an announced inspection on 8 May 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. We focussed on two key questions in relation to care and treatment; is the care safe, and is the care well-led. At that time we judged that the care provided was safe. We judged the practice was not providing well-led care in accordance with Regulation 17 ‘good governance’ of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for My Dentist Langham Road on our website www.cqc.org.uk

We undertook a follow up focused inspection of My Dentist Langham Road on 2 July 2018. This inspection was carried out to review in detail the actions taken by the practice to improve the governance and the quality of care and to confirm that the practice was now meeting legal requirements.

Our findings were:

Are services well-led?

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

Background

My Dentist – Langham Road is in the town of Blackburn, Lancashire and provides NHS and private treatment to adults and children.

The practice is located on a road set on a steep hill. There is level access to the downstairs reception and waiting area, suitable for people who use wheelchairs and those with pushchairs. There are two treatment rooms located on the ground floor. At the time of this inspection, one of these was out of use. The surgery in use is accessible for patients with limited mobility. A further treatment room is available on the first floor of the practice. Car parking is available outside the practice on the residential street.

The dental team includes two dentists and two dental nurses. The team is supported by a practice receptionist. The practice manager works between this practice and a second practice nearby.

The practice is owned by a corporate provider, Whitecross Dental Care Ltd. As a condition of registration, they 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 My Dentist Langham Road is the practice manager.

During the inspection we spoke with two dentists, one dental nurse and a practice manager. We spoke with the organisation’s lead regulatory officer, and an area development manager. The organisation has appointed a new practice manager and this staff member is currently undergoing training for this new role. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from Monday to Friday 9am to 1pm and from 2pm to 5.30pm.

Our key findings were:

• The practice had implemented and improved their systems to help them manage risk.
• The practice had updated leadership arrangements.
• The practice staff could talk about and demonstrate infection control procedures which reflected published guidance. We did note that staff were not routinely using the washer disinfector machine, but were continuing to manually clean dental instruments.
• The practice had staff recruitment procedures in place that reflected regulatory requirements.
• Staff training for all staff had been reviewed and updated.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• The practice staff had suitable information governance arrangements.
• We saw some evidence of audit at the practice.

There were some areas where improvements could be made. The provider should:

• Review protective equipment for staff working in the decontamination room so that heavy duty rubber gloves are available for those who manually clean dental instruments.

We carried out this announced inspection on 8 May 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.

On this inspection we focussed on two key questions in relation to care and treatment.

• Is it safe?

• Is it 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 well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Background

My Dentist – Langham Road is in the town of Blackburn, Lancashire and provides NHS and private treatment to adults and children.

The practice is located on a road set on a steep hill. There is level access to the downstairs reception and waiting area, suitable for people who use wheelchairs and those with pushchairs. There are two treatment rooms located on the ground floor. At the time of this inspection, one of these was out of use. The surgery in use is accessible for patients with limited mobility. A further treatment room is available on the first floor of the practice. Car parking is available outside the practice on the residential street.

The dental team includes two dentists and two dental nurses. The team is supported by a practice receptionist. The practice manager works between this practice and a second practice nearby.

The practice is owned by a corporate provider, Whitecross Dental Care Ltd. As a condition of registration they 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 My Dentist Langham Road is the practice manager.

During the inspection we spoke with two dentists and one dental nurse. We spoke with the organisation’s lead regulatory officer

, an area development manager

and a relief practice manager who was providing holiday cover for the permanent practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from Monday to Friday 9am to 1pm and from 2pm to 5.30pm.

Our key findings were:

• The practice staff appeared clean and well presented.
• The practice staff had infection control policies which generally reflected published guidance. We found some staff lacked understanding in relation to the correct processes to follow to maintain infection prevention and control standards.
• 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 staff had suitable safeguarding processes in place and most staff understood their responsibilities for safeguarding adults and children.
• The practice had recruitment processes in place for recruitment of dental nurses and administrative and support staff. Our checks showed these were not always followed.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Leadership at the practice required improvement.
• Some governance processes were not uniformly followed by all staff.
• Further training of some staff was required, for example, in relation to management of legionella, the governance around cleaning of instruments and on the equipment used in the cleaning process, and in the Mental Capacity Act.
• Audit of patient treatment and outcomes was required to ensure a quality service.
• The practice staff dealt with complaints positively and efficiently.

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider is not meeting are at the end of this report.

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

• Review the practice’s protocols to ensure audits of radiography and infection prevention and control are undertaken at regular intervals to improve the quality of the service. The practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

We carried out this announced inspection on 8 May 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.

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

My Dentist Langham is in Blackburn and provides mainly NHS with some private treatment to adults and children.

There is level access for people who use wheelchairs and for pushchairs. There is public off street parking available near the practice.

The dental team includes two dentists, two dental nurses (one of which is a trainee), and two receptionists. The practice has two 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 - Langham - Blackburn was the practice manager.

On the day of inspection we collected 24 CQC comment cards filled in by 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 regulatory manager 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 –Friday 9am – 5:30pm.

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.

We spoke with four people who used the service. All the people we spoke with were happy with the care and treatment they received at the dental practice on the day of our visit. One person told us, "The service I received today was excellent”. A comment from a completed compliments leaflet was, "The practice always accommodates our busy lives and allows us to come together as a family".

People spoken with told us they were usually able to get appointments to suit their needs and received reminders when their appointments were due. This helped to ensure people received treatment in a timely manner.

People told us they felt safe when visiting the practice. One person told us, “I have been coming for a long time and would recommend the practice to others”.

On the day of the visit we found the practice to be safe, clean and well maintained. People told us the practice seemed clean whenever they visited.

Staff told us they felt well supported and we found they had the necessary skills and training to undertake their role in a safe and appropriate manner.