We carried out this announced inspection on 9 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 and Healthwatch that we were inspecting the practice. They did not provide any information.

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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

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

Background

Mydentist – New Canal - Salisbury is situated in the centre of the city above shops in one of the main streets. There are good bus routes to the practice from around the city. It provides NHS and private treatment to patients of all ages.

There is no level access into the building which is located on the first and second floors with no internal lift access to the second floor. The practice has made arrangements with another nearby dental practice in the company to take patients requiring level access. There is parking in nearby public car parks.

The dental team includes six dentists one of whom is an implantologist, two hygienists, three dental nurses and three trainee dental nurses, a practice manager and three receptionists. The practice has five 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 – New Canal - Salisbury was the practice manager.

On the day of inspection we collected 18 CQC comment cards filled in by patients and spoke with three other patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, two dental nurses and one trainee dental nurse, two receptionists 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 08.30am - 5.00pm.

·Out of hours information displayed on website and via telephone answering service.

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 mostly thorough staff recruitment procedures. They did not ensure the relevant pre-employment checks had been completed for agency staff used.
• 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, 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 recruitment procedures relating to the use of agency staff to ensure that appropriate background checks are completed prior to them working in the practice.

• Review the systems and processes in place to ensure referrals to other professionals are followed up in a timely way.

• Review the record keeping systems and processes in place to ensure all actions taken in relation to the regulated activities are appropriately recorded, signed and dated in accordance with good record keeping guidance.

We spoke with five people attending the practice either for a routine check-up or treatment during our inspection visit.

People described their experiences of the practice. The majority of people spoke positively of the service they received.

Comments included “They are very friendly and put you at ease” and "I have no worries or concerns, they are very nice." People told us they had no difficulties making appointments, although appointments often ran late. One person told us “there’s always a wait.”

The people we spoke with said they were given information about the options available to them. People said they were aware of the cost of treatments. One person said “they like you to pay up front.” Another person said “you go along with it because it’s NHS. They always advise you to see the hygienist, who is private.”

We asked people for their views on the cleanliness of the practice. People told us they found the practice to be clean. They told us staff wore appropriate protective clothing such as aprons, gloves and masks.

There was information available to advise people how to raise a concern or make a complaint, if necessary. One person told us about their experience of making a complaint. They said it had been dealt with satisfactorily.