We carried out an announced comprehensive inspection on 23 February 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 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 - Moseley Avenue – Coundon is a general dental practice in the Coundon area of Coventry. The practice is part of a large group of practices nationwide.

The practice has eight treatment rooms and offers NHS treatment to adults and children. Certain treatment options are available funded privately. Dental implants are available and treatment is carried out by a visiting implantologist. A dental implant is a metal post which is placed into the jaw bone; one or more of these may be used to support a false tooth or teeth.

The practice has 11 dentists, two dental hygienists, 12 qualified dental nurses and two trainee dental nurses supported by a practice manager and five receptionists.

The practice is open from 8 am to 8 pm on Monday to Friday and 9 am to 1 pm on a Saturday.

The practice manager is 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 of 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. We received feedback from 47 patients. These provided a positive view of the services the practice provides. Patients commented on the quality of care, the polite and friendly nature of staff and the cleanliness of the practice.

Our key findings were:

• The practice was visibly clean and clutter free.

• Comments from patients indicated that the staff were kind and caring and were skilled at putting nervous patients at ease.

• The practice met the standards set out in national guidance regarding infection control.

• A routine appointment could be secured within a couple of weeks and emergency appointments would be arranged within two days according to the need of the patient.

• The practice had policies in place to assist in the smooth running of the service.

• The practice had medicines and equipment to treat medical emergencies.

• Dentists at the practice used national guidance and standards in the care and treatment of patients.

• There was appropriate equipment for staff to undertake their duties, and most equipment was well maintained. However there was not an effective system to ensure that maintenance was carried out in a timely manner which had resulted in a delay to a piece of equipment.

• Some governance arrangements were in place for the smooth running of the service.

• Management of Legionella risk was not effective. Risks were not fully identified and actions taken to mitigate the risks were not completed in a timely manner.

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

• Review the current legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures, giving due regard to the guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance. Review the process for responding to concerns recognised through monitoring.

• Review the practice protocols regarding records of prescription forms with reference to the NHS guidance on security of prescription forms August 2013.

• Review the documentation around placement of dental implants, with reference to the assessment of patients and consent process.

People spoken with were happy with the service they received. One person told us “It’s a really good practice I am very pleased with the service I get.” Another told us “I find them exceptionally good, it’s a friendly practice.”

People we spoke with said that everything in the practice always looked clean and tidy. People confirmed that the dentists and nurses offered them glasses to protect their eyes during treatment. We were told the dentists wore these themselves and that they always wore disposable gloves.

People told us that they do not have to wait very long to see the dentist, one person said “I have never had to wait very long when I arrive, a couple of minutes at most.”

We asked dental staff how the surgery decides on a treatment plan with a person. We were told this would depend on the oral health assessment that is completed at the start of each course of treatment. We were shown a completed assessment and people we spoke with told us everything was always explained to them. One person told us “My dentist is good at explaining what treatment she is going to do and why you need it."

We observed the decontamination process and the nurse described how the equipment was monitored to ensure it was working efficiently. Staff spoken with told us that they had attended training in infection control and the decontamination of equipment. Staff said they felt confident with this procedure.

We looked at the results of the last patient satisfaction survey and the comments people had made about the service. Comments included,

“The service is brilliant. They have got all the different methods to use. They know what they are doing.”

“My dentist is always friendly and makes me feel secure and confident when treatment is being carried out.”

We asked if people had ever had to make a complaint. People we spoke with said they would speak to the manager if they were unhappy with anything but had never had cause to do this.