We carried out this announced inspection on 31 October 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 and Healthwatch 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

Mydentist - Quay Road - Bridlington provides NHS and private treatment to adults and children.

There is a permanent ramp for people who use wheelchairs and pushchairs. Car parking spaces, including are available near the practice.

The dental team includes five dentists, 12 dental nurses (four of whom are trainees), a dental hygiene therapist and three receptionists. They are supported by a practice manager and a full compliance team at head office.

The practice has six surgeries, two on the ground floor and four on the first floor, a dedicated room for taking Orthopantomogram (OPG) X-rays, a decontamination room for sterilising dental instruments, a staff room/kitchen and a general office.

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. The registered manager at Mydentist - Quay Road - Bridlington was the practice manager.

On the day of inspection we collected 38 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with four dentists, four dental nurses, a receptionist, the practice manager and a member of the compliance team. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday – Friday 8am – 5:30pm

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. 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.
• 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.

We identified areas of notable practice.

We identified a commitment to improving outcomes for patients through effective leadership within the practice, staff felt empowered and were confident in their roles which had a positive impact on staff, patients and the local community.

• The practice manager had established a charity to support schools locally and this had now evolved nationally in areas of deprivation. The charity worked with schools to raise awareness of oral health and provide preventative fluoride treatments. We were told over 30,000 children were now part of this programme.
• The prevention programmes they had embedded within the practice empowered staff to learn new skills which could be utilised to provide this programme, including oral health and fluoride varnish .certification
• Evidence was available to show this programme had reduced the need for access to secondary care hospital admissions for general anaesthesia by 19.5%.
• The charity’s ethos had been adapted to be used in the dental practice and this had been used to implement an in practice prevention (IPP) programme for children aged 0-3 and 3-16. A detailed questionnaire was completed at the start of the programme and children and parents were offered three appointments so time could be spent improving preventative awareness and modifying behaviour.
• Siblings of patients identified who could benefit from the programme were also included in the programme to ensure families’ prevention awareness was reinforced.
• The diet advice and sugar advice given also included raising awareness about obesity
• We believe this to be notable practice which is worth sharing.

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

• Review the practice safe working systems and local rules for the X-ray equipment to ensure this cannot be used by members of the public.