We carried out this announced inspection on 21 September 2017 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 have any relevant information to share with us regarding this dental practice.

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

The Mydentist Dental Practice in Chilwell is located in Nottingham. The practice provides mostly NHS dental treatment (90%) and some private dental treatment (10%) to patients of all ages.

The practice is located on two floors with ramped access to the front door. There are two treatment rooms, both of which are located on the ground floor. There is road side car parking in the area.

The dental team includes four dentists; one dental hygienist/ therapist; four qualified dental nurses; two trainee dental nurses, and one practice manager.

The practice is owned by an organisation 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 practice manager was the registered manager at Mydentist Chilwell.

On the day of inspection we collected 41 CQC comment cards filled in by patients. We also spoke with one patient in the practice. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, two dental nurses and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice opening hours are: Monday: 9 am to 8 pm, Tuesday: 9 am to 5:30 pm, Wednesday: 9 am to 8 pm, Thursday: 9 am to 5:30 pm, Friday: 9 am to 4 pm and Saturday: 9 am to 5 pm.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which followed published guidance.
• The practice asked staff and patients for feedback about the services they provided, and received positive feedback.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risks in the practice, particularly with regard to health and safety.
• The practice had suitable safeguarding processes. Staff had been trained and knew their responsibilities for safeguarding adults and children.
• The practice 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 measures to protect their privacy and personal information.
• Staff had not received regular appraisal of their performance.
• The practice completed regular audits and used the information to make improvements.
• The appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The practice dealt with complaints positively and efficiently.

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

• Review the current performance review systems in place and have an effective process established for the on-going assessment and supervision of all staff.

We previously inspected School Lane Dental Centre on the 15 November 2013. Following that inspection we had concerns relating to the assessment and monitoring of the quality of the service. We had found that documentation related to clinical audits were incomplete, as were the health and safety action plans. In addition we found that formal methods of receiving feedback from patients were not working effectively.

We therefore returned to check that these issues had been addressed

On this occasion we did not speak with any patients but concentrated on staff personnel files and documentation.

We spoke with one member of staff who showed us the completed action plans, clinical audits and explained how formal feedback was being received and used to improve the quality of the service.

The names ‘Charlotte Murphy’ and ‘Kathryn Stenson’ appear on our report as being the registered managers at the service. At the time of our inspection these people were not registered managers at the service. We have requested that the provider addresses this to ensure the correct details are held on our register.

During our inspection we spoke with six people who used the service, four members of staff and the person in charge at the time of our inspection.

People told us they were happy with the care and treatment they received. One person said, “I always find it to be very good here. The staff are efficient and attentive”. Another person said, “The staff are excellent. I always feel relaxed when I come here”.

People told us they were treated with respect and were involved in the planning of their treatment.

Care and treatment was based upon clinical guidelines and individual need, and people told us they were treated with care and compassion. People were cared for and treated by staff who had the appropriate knowledge and skills to meet their needs.

During our inspection we saw that the premises were clean and tidy. We observed staff following policies and procedures to protect people from the risks associated with infections.

We saw that there were systems in place to assess and monitor the quality of the service. However, some of these systems were ineffective. This meant that improvements to the service were not always made in a timely manner.