We carried out a short follow up visit on 9 December 2015 to check whether the practice had taken action to address a breach of Regulation 17(2)(a)(b) and (d)(i) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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 well-led?

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

Background

Mydentist - Whittlesey Road Stanground (previously registered as 1A Dental Practice Stanground) provides primary dental care and treatment to patients whose care is funded through the NHS and to a small number of patients who pay privately. The service is part of the 1A Group Dental Practice Partnership owned by a large provider of dental care the Mydentist Group. The practice currently employs one full time dentist with part time locum cover. A new dentist has been employed and will commence post in the near future. There is a lead dental nurse, a second dental nurse and one trainee dental nurse supported by a receptionist. The practice manager works two days a week at the location and three days a week at another dental practice in the area. The practice opens 8.30am to 5pm Monday to Friday.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

During this inspection we reviewed the provider's action plan in response to the shortfalls we found at the last inspection, visited the service to speak with the practice manager and reviewed records held at the service. We found the practice had taken the appropriate action.

Our key findings were;

• All employed staff had an appropriate level of criminal records check completed.
• Staff received training, support and personal development appropriate to their roles.
• Systems to monitor the quality and safety of the service had been improved.

We carried out an announced comprehensive inspection on 5 May 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 a responsive service 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.

1A Dental Practice in Stanground provides primary dental care and treatment to patients whose care is funded through the NHS and to a small number of patients who pay privately. The service is part of the 1A Group Dental Practice Partnership owned by a large provider of dental care the IDH Group. The practice employs two dentists, two dental nurses, two trainee dental nurses and a receptionist. The practice manager works half time at the location and half at another dental practice in the city. The practice opens from 8.30am to 5pm Monday to Friday.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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 spoke with three patients and received a total of 13 CQC comments cards from patients who had visited the practice in the two weeks before our inspection. They told us staff were welcoming, kind and helpful and they valued the service they had received. Two patients told us they had advised  family members to use the service and they had also had a positive experience of care and treatment at the practice.  

Our key findings were:

• A range of safety systems were in place to identify risks such as safety incidents and learning was shared with staff. 
• Infection control procedures were well managed to ensure that equipment was maintained for safe use.
• Patients received care and treatment to promote their dental health in line with clinical guidelines.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in decisions about it
• Patients were treated with dignity and respect and confidentiality of their personal information was maintained
• Staff were kind, caring, competent and put patients at their ease.
• We reviewed 13 comment cards and spoke with three patients who valued the service they received.

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

• Ensure that records are kept of staff induction and that staff have received appropriate training and supervision to carry out the duties they are employed to perform to ensure that patients receive safe, quality care.
• Ensure that robust checks of the emergency medicines are in place so that appropriate medicines are available in accordance with guidelines detailed within the British National Formulary.
• Ensure that all audits are recorded and action plans are clearly recorded to demonstrate that improvements have been completed. 
• Ensure that all staff working with vulnerable people have appropriate checks with the disclosure and barring service.

You can see full details of the regulations not being met at the end of this report.

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

• Ensure that information and contact details for local safeguarding teams are easily accessed by the staff team if urgent contact is required.
• Offer patients a copy of their referral letter when they are referred for further treatment.
• Consider providing the patient survey to patients in alternative formats. 
• Ensure that all staff are familiar with the Mental Capacity Act 2005.