We carried out this announced inspection on 20 November 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 providing well-led care in accordance with the relevant regulations.

Background

My Dentist Park Avenue is in Barnoldswick, East Lancashire and provides NHS and private treatment to adults and children.

The dental practice is located on the ground floor of a converted terraced property. There is domestic living accommodation above the practice. All review of risk assessments and safety checks at this inspection were for the dental practice only.

There is level access for people with limited mobility and for those with pushchairs. Patients who are wheelchair users may have to use a neighbouring My Dentist practice, which has facilities to accommodate larger wheelchairs. Car parking is available on the road outside the practice.

The dental team includes three dentists, four dental nurses, one dental hygiene therapist and one practice manager. The practice also retains the services of a cleaner. The practice has two treatment rooms, a reception desk and patient waiting area. There is no dedicated decontamination facility. All decontamination work is managed within each surgery.

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 My Dentist Park Avenue is the practice manager.

On the day of inspection, we collected 12 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists, two dental nurses, the receptionist and the 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, from 9am to 1pm and from 2pm to 5.30pm. The practice is open on Saturday from 9am to 2pm.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had effective infection control procedures in place. In instances where these did not reflect published guidance, we saw that they were effectively managed.
• 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 provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• 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.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had information governance procedures in place. Small changes to these were required to ensure all dentists had sufficient indemnity arrangements in place at all times.

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

• Review the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities. In particular, the checks in place to confirm that sufficient indemnity is in place for all clinicians at all times.

We carried out an announced comprehensive inspection on 15 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 - Park Avenue – Barnoldswick offers a full range of dental treatments including preventative and corrective treatments for mainly NHS children and adult patients with some private treatment available. The practice is based in Barnoldswick in Lancashire. The dental team consists of three dentists, four dental nurses (two of which are trainees), a receptionist and a cleaner.

The practice is in a converted building. There are two treatment rooms and a waiting/ reception room. Parking is available next to the practice. The opening hours are Monday – Friday 9am-5:30pm, with Saturday opening 9am-2pm.

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 in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

Our key findings were:

• The premises wasvisibly clean and tidy.
• The practice had procedures in place to record and analyse significant events and incidents.
• Staff had received safeguarding training, and knew the process to follow to raise concerns.
• There were sufficient numbers of suitably qualified, skilled staff to meet the needs of patients.
• Staff had been trained to deal with medical emergencies. Emergency medicines and equipment were available.
• Patients’ needs were assessed, and care and treatment were delivered, in accordance with current legislation, standards, and guidance.
• Patients received information about their care, proposed treatment, costs, benefits, and risks and were involved in making decisions about it.
• Staff were supported to deliver effective care, and opportunities for training and learning were available.
• Patients were treated with kindness, dignity, and respect.
• The appointment system met the needs of patients, and emergency appointments were available.
• Services were planned and delivered to meet the needs of patients, and reasonable adjustments were made to enable patients to receive their care and treatment.
• The practice gathered the views of patients and staff and took their views into account.
• Staff were supervised, felt involved, and worked as a team.

We spoke with four people who used the service. They all said they were happy with the care and treatment they received at the dental practice. One person told us, "I wish I’d come 20 years ago. The dentist is so helpful”. A comment from a recent patient survey was, "I have only just registered but am impressed with the friendly nature of all the staff”.

People spoken with told us they were always able to get appointments to suit their needs and received reminders to let them know when their appointments were due. This meant people received treatment in a timely manner.

People told us they felt safe when visiting the practice. One person told us, “The dentist makes you feel at ease".

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.