We carried out this announced inspection on 18 September 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

Mydentist - Stapleford is located in a medical centre on the outskirts of Nottingham. The practice provides both NHS and private dental treatment to adults and children.

There is external ramped access from the street into the practice with automatic wide doors. Alternatively there is a passenger lift, and level access throughout the practice. This is of benefit for people who use wheelchairs and those with pushchairs. There is a car park at the practice, or roadside parking is available in the area around the practice. Car parking includes spaces for blue badge holders.

The dental team includes two dentists, one dental hygienist, two qualified dental nurses, one trainee dental nurse, two reception staff and one practice manager. The practice has two treatment rooms which are both located on the first floor with access via a ramp, a flight of stairs or the passenger lift.

The practice is owned by a 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 did not have a registered manager at the time of this inspection. A newly appointed practice manager was in the process of applying to be the registered manager.

On the day of inspection, we received feedback from 30 patients.

During the inspection we spoke with two dentists, 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 is open: Monday: 8.30am to 5.30pm; Tuesday: 8.30am to 8pm; Wednesday: 8.30am to 5.30pm; Thursday: 9.30am to 8pm; Friday: 8.30am to 5pm. The practice is open alternate Saturdays: 9am to 12.30pm. The practice is closed on Sundays.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• The records for infection control audits were limited.
• 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• Not every X-ray machine was fitted with rectangular collimation.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.

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

• Review the practice’s infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’. In particular ensure that six monthly infection control audits are completed and the records available for inspection.

• Review the practice's protocols and procedures for the use of X-ray equipment in compliance with The Ionising Radiations Regulations 2017 and Ionising Radiation (Medical Exposure) Regulations 2017 and taking into account the guidance for Dental Practitioners on the Safe Use of X-ray Equipment.

We spoke to two patients, observed other patients attending the practice (with their consent) for appointments and two members of staff.

Patients told us they received enough information to help them make informed choices in regards to the care and treatment they received. They told us that staff spoke to them in a kind and respectful manner.

One patient told us they were involved in the decisions about their care and they were given options and choices about the treatment they would receive.

We saw signs in reception that told patients there were rooms available to have discussions in private, if they wished to do so. We also saw signs that told patients the practice had systems in place if their first language was not English.

We found there was suitable access for people with mobility difficulties and there was a system in place for people who were hearing impaired.

We saw staff received training and supervision to ensure they were qualified to do their job.

We found the practice to be clean and well maintained. We saw staff wore the appropriate clothing protection to ensure they adhered to the code of practice for infection control.

We found systems in place to ensure risks to the practice was managed and safe.