We carried out this announced inspection on 6 December 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 that we were inspecting the practice. They had no 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

Angel Dental Implant Centre is located in the London borough of Brent and provides NHS and private treatment to patients of all ages.

There is access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

Practice staffing consists of a principal dentist, two dentists, one hygienist, two dental nurses and a practice manager.

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 Angel Dental Implant Centre was the practice manager

The practice is open Monday to Friday 9am to 5.30pm.

The practice facilities include two treatment room a decontamination room, X-ray room, reception/waiting area, office and a staff room.

On the day of inspection we collected feedback from 46 patients. This information gave us a positive view of the practice.

During the inspection we spoke with the, one dentist, hygienist two dental nurses and the Practice manager. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• 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 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.
• Staff knew how to deal with emergencies. However some items of life-saving equipment and medicines as per current national guidelines were not available or were past their expiry date. The practice responded immediately to procure these pieces of equipment.

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

• Review the protocols and procedures for use of X-ray equipment taking into account Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.
• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.
• Review practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.
• Review the staff supervision protocols and ensure an effective process is established for the on-going appraisal of all staff

Patients were happy with the quality of service and standard of treatment provided at the dental practice. Staff were described as ‘wonderful people’ and ‘very friendly’. Patients told us they had recommended the service to others. One patient had commented on a satisfaction survey form that ‘nothing was ever too much trouble’ for the dentist and staff. Effective systems for infection control were being implemented in the practice and instruments were safe to use.