We carried out this announced inspection on 1 March 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information of concern.

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 - New Chester Road - Wirral is in Birkenhead and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and pushchairs. The practice has a dedicated car park with designated parking for blue badge holders.

The dental team includes three dentists, 10 dental nurses (two of whom are trainees), one dental hygienist and two receptionists. The practice has five treatment rooms.

The practice is owned by a company 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. At the time of the inspection the practice did not have a registered manager in post. The practice was currently recruiting a new practice manager who would be the registered manager.

On the day of inspection we collected 15 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, two dental nurses, the regulatory officer and the stand-in practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday and Wednesday to Friday from 9:00am to 5:45pm

Tuesday from 9:00am to 7:00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance. Clinical waste disposal procedures could be improved.
• 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 had suitable safeguarding processes and staff 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.
• Leadership at the practice had not been effective which had resulted in failings in some processes and procedures.
• The practice asked staff and patients for feedback about the services they provided.

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

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review the practice’s waste handling policy and procedure to ensure waste is segregated and disposed of in accordance with relevant regulations giving due regard to guidance issued in the Health Technical Memorandum 07-01 (HTM 07-01).
• Review the practice’s process for obtaining Hepatitis B titre levels for staff.
• Review its complaint handling procedures to ensure complaints are received, recorded, handled and responded to in line with the practice policy.

We spoke with six patients. Patients told us they were happy with the service provided. They said the dentist always explained what they were doing, the treatment options available including risks and benefits and the costs involved. They said the dentist was “very friendly”, "a great fellow” and explained everything including the cost of treatment.

We checked three people's dental records and found evidence of appropriate dental examinations, assessments, treatment planning and advice. Records showed that x-ray machines were regularly maintained and serviced.

The provider had appropriate infection control/decontamination policies and procedures in place and we saw the relevant guidance for the cleaning of dental instruments was followed. Contracts were in place and up to date for clinical waste and the maintenance of sterilisation equipment.

We reviewed staff records and saw the provider had undertaken appropriate checks in the employment of staff. Staff were appropriately qualified and registered with the General Dental Council (the organisation that regulates dental professionals in the UK). Staff had

received annual training in cardiopulmonary resuscitation (CPR) and the practice was well equipped to deal with medical emergencies.

A simple, easy to read complaints policy advised patients how to make a complaint. Patients we spoke with said they had no complaints or concerns. We reviewed one complaint which the provider had responded to appropriately.