We carried out this announced inspection on 28 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 that we were inspecting the practice. We did not receive any information of concern from them.

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

Ocean Dental is in Manchester city centre and provides NHS and private treatment to adults and children.

The practice is located on the second floor of The Arndale Centre which is a large shopping complex. There is lift access for people who use wheelchairs and pushchairs. The Arndale Centre has a car park, including spaces for patients with disabled badges.

The dental team includes seven dentists, five dental nurses (two of whom are trainees), three part-time dental hygienists, a treatment co-ordinator, a clinic manager and a receptionist. The practice has four treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we collected 23 CQC comment cards filled in by patients and spoke with two other patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, one dental nurse and the clinic manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Thursday: 8.30 am to 7.30 pm

Friday: 8.30 am to 6.00 pm

Saturday: 9.00 am to 6.00 pm

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. Improvements were needed to the availability of some emergency equipment.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes. Not all staff had received training but they 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 care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The practice had effective leadership. 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 dealt with complaints positively and efficiently.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.
• ​Review staff training to ensure that dental nursing staff who are assisting in conscious sedation have the appropriate training and skills to carry out the role giving due regard to guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.

On our last visit to Ocean Dental Manchester on 31 October 2012 we found that patients who used the service were at risk of not being kept safe because there were significant gaps in the practice safeguarding policies and procedures and staff had not received any training in relation to safeguarding. We asked the provider to take action to address this concern.

On our visit on 8 July 2013 we saw that the policies and procedures had been updated with the correct information and that the majority of staff had now received the required training. The small number of staff who had not as yet completed this training were booked onto the next available course.

Ocean Dental Manchester provided dental treatments to adults and children in bright, modern, new facilities, which provided good access to disabled patients.

One patient commented on the surgery, ‘…seems well equipped and very clean.’ We too observed that waiting areas and surgeries were clean and maintained to a good standard.

Patients we spoke to told us it was important to them that they saw an NHS dentist and because there weren’t many NHS dentists in the city centre they chose Ocean Dental Manchester.

Patients told us they were given information about treatment options before making a decision about their treatment. One patient said, “…the dentist explained the treatment every step of the way. She told me what was happening and what to expect. I have been quite impressed.”

We were told that there was a four week waiting list for appointments. Patients told us it was fairly easy to get an appointment and one patient said, “They are good if I have to cancel. They try and fit me in as soon as they can.” And “He’s (the dentist) very accommodating and they offer flexible appointments.”

Dental nurses employed at the practice were registered with the General Dental Council.

Patients told us that they had never made a complaint and that they were more than satisfied with the service provided.