We carried out an announced comprehensive inspection of this service on 10 November 2015 as part of our regulatory functions where a breach of legal requirements was found. After the comprehensive inspection, the surgery wrote to us to say what they would do to meet the legal requirements in relation to the breach.

We followed up on our inspection of 10 November 2015 to check that the surgery had implemented their plan and to confirm that they now met the legal requirements. We carried out a desk based review on 5 July 2016 to check whether the practice had taken action to address a breach of Regulations 17(1) (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

This report only covers our findings in relation to those requirements. We have not revisited City Dental because they were able to demonstrate that they were meeting the standards without the need for a visit.

Our findings were:

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for City Dental on our website at www.cqc.org.uk.

We carried out an announced comprehensive inspection on 10 November 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 not providing well-led care in accordance with the relevant regulations.

Background

The practice is owned by City Dental (Dental Prosthetics) Limited. The practice is located at 57 Dovedale Road, Seaburn Dene, Sunderland, Tyne and Wear, SR6 8LP.

The practice is open Monday to Friday 8am to 5pm.

The practice predominantly provides dental prosthetics and general dental services to private patients.

There are two clinical dental technicians, a dental nurse and a dentist. The practice has two treatment rooms.

City Dental (Dental Prosthetics) Limited is the registered provider for the practice. The practice also has a registered manager. 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.

We received feedback from patients about the service via three Care Quality Commission comment cards. All the comments were positive about the staff and the services provided. Comments included: staff are efficient, helpful and professional.

Our key findings were:

• There was an effective complaints system.
• Staff had received safeguarding training, knew how to recognise signs of abuse and how to report it.
• There were sufficient numbers of suitably qualified staff to meet the needs of patients.
• Staff had been trained to manage medical emergencies.
• Infection control procedures were in accordance with the published guidelines.
• Patient care and treatment was planned and delivered in line with evidence based guidelines and current regulations.
• 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.
• Patients could access routine treatment and urgent care when required.
• The practice sought feedback from staff and patients about the services they provided.

We identified regulations that were not being met and the provider must:  

• Carry out audits of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. Practice should also check all audits have documented learning points and the resulting improvements can be demonstrated.
• Establish a process to ensure that frequency of taking X-rays is in line with the Faculty of General Dental Practice(FGDP) guidelines and the guidance is followed in respect of endodontic treatments in all cases.

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

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

• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team

Patients told us they were given good information about treatment and the options available to them. They also told us the practice had useful written information which was freely available at the surgery. They also told us they received good information from the provider’s website. One patient told us, “I had everything explained to me, including the cost of the treatment. There were no surprises about the treatment or the cost”. Another patient told us, “When you pay for your treatment you make sure you have all the information you need before making your decision”.

We found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. The practice manager and the dental nurse told us about patients’ treatment and the arrangements which ensured patients received appropriate care in line with their wishes.

We spoke with patients about the treatment they received at City Dental. They told us they received good service and were happy with the treatment and care they received. One patient told us, “I am extremely happy with the treatment I got from City Dental. They are wonderful. They make you feel special”. Another patient told us, “I can say they have given me a lot of support and gave me a lot of confidence. They were very sensitive to my needs and treated me with respect”.

Patients we spoke with told us there was always the opportunity to comment on the practice and the services provided.