We carried out this announced inspection on 8 November 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 Care Quality Commission inspector who was supported by a specialist dental adviser.

We told the NHS England area team that we were inspecting the practice. They provided information which we took into account.

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

29 New Rd Dental Practice is in the London Borough of Tower Hamlets and provides NHS and private treatment to patients of all ages.

There are some steps to access the entrance of the practice. Car parking spaces near the practice are limited.

The dental team includes three dentists, two dental nurses, a dental hygienist, a receptionist and the practice owner/manager. The practice has two treatment rooms in use.

The practice is owned by an individual who is the principal dentist there. 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.

On the day of inspection we collected 19 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with a dentist, a dental nurse, the receptionist and the practice owner. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday- Friday 9:00am -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.

• The practice had systems to help them manage risk, although they required updating. There were some key identified high risk actions from a fire risk assessment and legionella risk assessment that had not been completed.

The provider responded appropriately within the required time frame to inform us of the actions they had undertaken to mitigate the risks.

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

• Review the current Legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures.

• Review the practice's current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.

We spoke with three people using the service during our visit. People were positive about the service they received at the practice. The practice served a diverse local population and the dental team were able to speak several languages.

The dentists assessed people’s medical history, their oral health and dental needs before providing treatment. The practice kept clear records of people’s treatment plans and obtained people’s consent before proceeding. People using the service told us they had confidence in their dental care and the dentists. One person said, “excellent service.” Another person said, “it’s good, I have used it for 20 years.” People told us they had enough information about their treatment.

The premises had recently been refurbished. The service was clean with effective systems to decontaminate equipment and instruments.

The dentists, dental nurses and hygienists were professionally registered. They had opportunities to keep their practice up to date. Staff members were positive about the service they provided and the support they received from colleagues and the practice owner.

Staff members were aware of their role as health professionals in safeguarding children and vulnerable adults from abuse. However staff were unclear about how to raise such concerns with the relevant agencies.