We carried out this announced inspection on 14 March 2019 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

Mydentist - Old Road - Clacton-on-Sea is in Clacton, Essex and provides 75% private and 25% NHS treatment to adults and children. The services are provided by two individually Care Quality Commission registered providers at this location. This report only relates to the provision of general dental care provided by Petrie Tucker and Partners Limited. An additional report is available in respect of the general dental care services which are registered under Whitecross Dental Care Limited.

The practice is located in two neighbouring buildings with two receptions and waiting areas. There is level access for people who use wheelchairs and those with pushchairs. There are some car parking spaces behind the practice. Alternatively, car parking spaces, including spaces for blue badge holders, are available in local car parks near the practice.

The dental team includes nine dentists, ten dental nurses and one trainee dental nurse, one hygienist, one treatment coordinator, one decontamination lead, one lead receptionist and an acting practice manager. In addition, there are two visiting dental implantologists who regularly attend the practice. The practice has ten 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. At the time of inspection there was no registered manager in post as required as a condition of registration. A registered manager is legally responsible for the delivery of services for which the practice is registered. In the absence of a registered manager, the lead regulatory officer and acting practice manager had overall responsibility for the management and clinical leadership of the practice. The acting practice manager was responsible for the day to day running of the service. Registered manager recruitment procedures were on-going.

On the day of inspection, we collected 21 CQC comment cards filled in by patients and spoke with two other patients.

During the inspection we spoke with five dentists, five dental nurses, the lead receptionist, the acting practice manager, the lead regulatory officer and the area development manager who attended from the provider’s support centre. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday from 8am to 8pm, Friday from 8 to 5pm and alternate Saturdays from 9am to 2pm.

Our key findings were:

• The practice was part of a large corporate group which had a support centre based in Manchester where support teams including human resources, IT, finance, health and safety, learning and development, clinical support and patient support services were based. These teams supported and offered expert advice and updates to the practice when required.
• The practice appeared clean and well maintained.
• The practice staff 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 provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The provider had thorough staff recruitment procedures. The practice had access to support from a dedicated human resources and recruitment team based within the company’s support centre.
• Staff appraisals had not been completed.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of 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 staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

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

• Review the training, learning and development needs of individual staff members at appropriate intervals and ensure an effective process is established for the on-going assessment, supervision and appraisal of all staff.

We carried out an announced comprehensive inspection on 16 July 2015 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.

The practice employs six dentists who undertake mainly NHS treatments with a small amount of private dental treatment. The practice offers conscious sedation for nervous patients.

The dentists are supported by a clinical support team consisting of seven dental nurses, four trainee dental nurses and two orthodontists. There is a practice manager, assistant practice manager, a reception manager and several receptionists. The practice has six surgeries, a dedicated decontamination room and several X-ray suites.

The practice is open Monday to Thursday between the hours of 8am and 8pm and Fridays between the hours of 8am until 5pm. They are also open Saturdays between 9am and 2pm.

We spoke with four patients during the inspection. They told us that they were very satisfied with the services provided, that the staff treated them with dignity and respect and the dentists provided them with a clear explanation of treatment including options and associated costs. They also commented positively on the efficiency of the nursing and reception staff.

We viewed CQC comment cards that had been left for patients to complete, prior to our visit, about the services provided. There were 40 completed comment cards and all of them reflected positive comments about the staff and the services provided, describing the clinical and support staff as kind and caring. The comments made in the CQC cards reflected that patients were extremely satisfied overall with the services provided at the practice. There was only one negative comment made and this related to a minor issue about the frequency of a follow-up visit.

The provider was providing care which was safe, effective, caring, responsive and well-led and the regulations were being met.

Our key findings were:

• The practice recorded and analysed significant events and complaints and cascaded learning to staff.
• Where mistakes had been made patients were notified about the outcome of any investigation and given a suitable apology.
• Staff had received safeguarding training and knew the processes to follow to raise any concerns.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.
• Infection control procedures were effective and instruments cleaned and sterilised in line with published guidance. Infection control audits reflected that systems were robust.
• Patients’ care and treatment was planned and delivered in line with evidence based guidelines, best practice and current legislation.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met the needs of patients and waiting times were kept to a minimum.
• There was an effective complaints system and the practice displayed a duty of candour.
• The practice was well-led and staff felt involved and worked as a team.
• Governance systems were effective and there was a range of clinical and non-clinical audits to monitor the quality of services.
• The practice sought feedback from staff and patients about the services they provided.
• There was a consistent approach to learning from all the staff at the practice.