We undertook a follow up desk-based focused inspection of Mydentist - Laughton Road - Dinnington on 2 January 2019. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector.

We undertook a comprehensive inspection of Mydentist - Laughton Road - Dinnington on 8 August 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulations 17 and 19 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 Mydentist - Laughton Road - Dinnington on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the areas where improvement was required.

Our findings were:

Are services well-led?

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

The provider had made improvements in relation to the regulatory breaches we found at our inspection on 2 January 2019.

Background

Mydentist Laughton Road Dinnington is in Sheffield and provides NHS and private treatment to adults and children.

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

The dental team includes three dentists, five dental nurses (two of whom are trainees), a receptionist and a practice manager. The practice has four 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 Laughton Road Dinnington is the practice manager.

Prior to the desk based focussed inspection, we received supporting evidence and written confirmation of action taken by the practice to address the areas previously identified as a breach of regulation.

The practice is open:

Monday and Tuesday 9am – 6pm, Wednesday, Thursday and Friday 9am – 5pm

Our key findings were:

• Infection prevention and control processes were embedded and carried out in line with published guidance.
• The management of safe sharps systems were now effective.
• Systems to monitor training and gather relevant training records were now effective.
• Effective recruitment procedures and relevant evidence gathering processes were now in place.
• The clinical waste segregation procedures were now embedded and in line with guidance.
• The practice had reviewed and improved its culture of continuous improvement.
• Clinical and information governance arrangements were updated and embedded within the team.

We carried out this announced inspection on 8 August 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 not providing well-led care in accordance with the relevant regulations.

Background

Mydentist Laughton Road Dinnington is in Sheffield and provides NHS and private treatment to adults and children.

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

The dental team includes three dentists, five dental nurses (two of whom are trainees), a receptionist and a practice manager. The company compliance manager was also present on the inspection day. The practice has four 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 Laughton Road Dinnington is the practice manager.

On the day of inspection we collected seven CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, three dental nurses and the receptionist. We also spoke with the practice manager and company compliance manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Tuesday 9am – 6pm, Wednesday, Thursday and Friday 9am – 5pm

Our key findings were:

• The practice appeared clean and well maintained.
• Improvements could be made to ensure the infection control procedures were fully embedded and were carried out in line with 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 to patients and staff. The safe sharps system in place was not effective.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children. Improvement was needed to monitor relevant training.
• Staff recruitment procedures and evidence gathering could be improved.
• Staff training was not effectively monitored.
• 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 provider was providing preventive care and supporting patients to ensure better oral health. The process to monitor gum disease was not consistent.
• The appointment system met patients’ needs.
• The clinical waste segregation process was not embedded.
• Management systems were not effective in some areas.
• The practice’s culture of continuous improvement was not effective in some areas.
• 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 provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements but was not up to date with new legislation.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.
• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

Full details of the regulations the provider was 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 and procedures for promoting the maintenance of good oral health taking into account the guidelines issued by the Department of Health publication ‘Delivering better oral health: an evidence-based toolkit for prevention’ In particular: periodontal pocket charting as a means of monitoring progress of gum disease or response to treatment.

People who we spoke with told us that they were very satisfied with the treatment provided at the practice. They told us they felt involved in discussions about their treatment. People told us that the dentist updated medical records at each visit. One person said "I have used the same dentist for many years and all my family now use the practice." People told us they were never kept waiting to see the dentist and that was important to them. Another person said "The dentist’s are excellent I would recommend them to anyone."

People said "The practice is always clean." The staff always take time to ensure all of my details are up to date before seeing the dentist." Another person said "Staff always wear protective clothing and offer me protective glasses. I always see the same dentist and if needed I can get an appointment at short notice."

People received treatment from suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work. There was an effective complaints system in place. Complaints people made were responded to appropriately.

People told us if they had any concerns or complaints they would discuss them with members of staff and they were confident in using the complaints system. One person said "We are able to complete satisfaction surveys and put them in the box, we are very happy with the practice."