We carried out this announced inspection on 5 April 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

We found this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

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

Are services well-led?

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

Background

MyDentist Aglionby Street Carlisle provides NHS and private treatment to patients of all ages.

There is stepped access to the building. For people who use wheelchairs and those with pushchairs there is a ramp available. Time limited car parking spaces are available near the practice and there is a long stay car park a short distance away.

The dental team includes four dentists, one dental hygienist, six dental nurses and two receptionists. There is a practice manager in post to support the team. The practice has four treatment rooms of which two are situated on the ground floor.

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 registered manager at MyDentist Aglionby Street was the practice manager.

On the day of inspection we collected 13 CQC comment cards filled in by patients.

During the inspection we spoke with four 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 to Friday 9.00am – 5.30pm.
• Saturdays 09.00am – 1.00pm by appointment.
• Closed Sundays.
• Out of Hours information is displayed on website.

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 staff 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 provider 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The practice staff dealt with complaints positively and efficiently.
• The practice staff had suitable information governance arrangements.

We spoke with two people who confirmed that the dentists and dental nurses always explained what they were going to do. We saw staff speaking to people in a respectful manner and staff understood privacy, dignity and confidentiality. People told us that they were "very happy" with the level of information they had and said they were “happy” with the service they received. However we found that there was limited ability for people to express their views as the practice had not implemented a formal patient satisfaction survey. People told us; “I always receive a good explanation from the dentist regarding my treatment,” and “I am always asked for my consent to treatment and my medical history is checked regularly.” The practice facilities were clean and well maintained. Protective equipment, including eye goggles, face masks and gloves were available.

Staff had received appropriate professional development and were able to obtain further qualifications. However the manager was aware that a formal system of appraisal required introduction. The practice had an effective system in place to enable them to regularly assess and monitor the quality of service that people received. We had not received any complaints or concerns about this service. However we found that there had been a total of 10 reviews recorded by people who used the practice on the NHS Choices website from March to October 2012. These were both positive and negative views.