We carried out an unannounced responsive inspection on 9 March 2017 to ensure the practice was providing effective care in respect of the regulations; we did not inspect other aspects of the service.

Our findings were:

Are services effective?

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

Background

Mydentist - Welsh Row is located in Nantwich and provides NHS and private treatment to adults and children.

Wheelchair users or pushchairs can access the practice through a portable ramp at the front door. Car parking spaces are available near the practice.

The dental team is comprised of three dentists, six dental nurses, one dental hygienist and a practice manager.

The practice has three surgeries one on the ground floor and two on the first floor, a reception and waiting area, a decontamination room, a staff room/kitchen and a general office.

The practice is open:

Monday, Tuesday, Wednesday and Friday 9am – 5:30pm

Thursday 9am – 7pm

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.

The key findings were:

• The practice appeared clean and well maintained.
• The practice had systems in place manage risks.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients. Patients were treated with dignity and respect and confidentiality was maintained.
• The appointment system met patients’ needs.

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

• Review its responsibilities in accordance with the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understood how to minimise risks associated with the use of and handling of these substances. Review the storage of products identified under (COSHH) Regulations to ensure they are stored securely.

At a previous inspection on 30 August 2013, we identified moderate concerns with cleanliness and infection control. We found that some of the equipment used in the decontamination process called ultrasonic cleaners had not been consistently checked in line with the Department of Health’s guidance. The provider subsequently sent us an action plan to say how they were going to become compliant with the Health and Social Care Act (2008) Regulations 2010.

At this follow up inspection, we carried out checks to ensure the provider had met their action plan.

We found that the equipment had been checked and as a consequence had been replaced. The new equipment was now checked on a regular basis. This meant that the consistent checks ensured that any failure of the machine could be detected and therefore reduce the risk of cross infection to patients.

The practice had not completed an up to date infection control audit but this was subsequently sent to us after our inspection. The checking of systems in place meant patients could be assured that the practice’s decontamination of dental instruments was being carried out in line with essential guidance to reduce the risk of cross infection.

We spoke with three people who were visiting the practice during our inspection. All made positive comments about the standard of treatment, facilities and services provided.

People told us that they were treated with respect and were always involved in making decisions about their care and treatment. One person said: “I am very happy with the service I have received at this dentist, overall they are excellent.”

People were asked about their medical history and we saw individualised clinical notes detailing assessment, risk assessment, examination and treatment planning.

We saw that emergency equipment was available and readily accessible to staff who had received training for cardio-pulmonary resuscitation and knew what to do in the event of an emergency.

Systems were in place to seek feedback from people using the service. Staff told us they welcomed feedback and we could see that patients’ views were taken into account in the way the service was provided and delivered.

We found that people were treated in a clean, and hygienic environment but were not adequately protected from the risk of cross infection because appropriate guidance had not always been followed.