We carried out an announced comprehensive inspection on 30 June 2016 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 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

4-6 George Street is a dental practice located in the London Borough of Richmond-upon-Thames. The premises are situated in a high-street location. There are two treatment rooms, a decontamination room, reception room with waiting area, patient and staff toilets, staff kitchen and administrative offices. All of the rooms are located on the first floor of the building.

The practice provides private dental care services to adults and children. The practice only offers specialist endodontic services on referral or by self-referral.

The staff structure of the practice consists of a principal endodontist, two associate endodontists, two dental nurses, a practice manager and a receptionist.

The practice opening hours are Monday to Friday from 9.00am to 5.30pm.

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.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Nineteen people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the British, European and American Endodontic Societies.

• There were effective systems in place to reduce and minimise the risk and spread of infection.
• The practice had safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• There were effective arrangements in place for managing medical emergencies.
• Equipment, such as the air compressor, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the staff team.
• There were arrangements for identifying, recording and managing risks through the use of risk assessments and audit processes. However, we identified some areas where these processes should be improved.

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

• Review the practice’s system for 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 recruitment procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review audit protocols to ensure audits of various aspects of the service are undertaken at regular intervals and, where applicable, learning points are documented and shared with all relevant staff.
• Review the practice’s system for environmental cleaning taking into account current national guidelines. .
• Review the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely.
• Review its responsibilities to the needs of people with a disability and the requirements of the equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.

People who use the service and dentists that had referred them told us they were satisfied with the treatment they had received and the way it was provided. One person said "I was very happy with my treatment and had no worries at all". "The consultation procedure and treatment was clearly explained including the cost". Another person told us "They answered my questions clearly and patiently". People were also told about any risks that might arise from treatments chosen and asked to sign a consent form before treatment took place. People felt treated with dignity and respect by staff and confirmed they had received consultations and treatment in private.

They did not comment on the practice safeguarding or infection control systems. They did tell us they thought the practice was kept clean, tidy and was well maintained.