We carried out an announced comprehensive inspection on 22 December 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

Bishopsgate Dental Care in Bishopsgate, London provides private dental treatment to patients of all ages. The practice also provides conscious sedation and minor oral surgery services. [Conscious sedation is a procedure using a combination of medicines to help a patient to relax (a sedative) and to block pain (an anaesthetic) during a medical or dental procedure. The patient remains awake during the whole procedure].

Practice staffing consists of a principal dentist, four associate dentists, orthodontic therapist, one hygienist, two dental nurses, one trainee dental nurse, one receptionist and a practice manager.

The principal dentist 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 practice is open Monday to Thursday 8am to 8pm and Friday 8am to 2pm

The practice facilities include three treatment rooms a decontamination room, reception/waiting area, one office and a staff room/kitchen.

40 patients provided feedback about the service. Patients who completed comment cards were very positive about the care they received from the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• The practice sought feedback from patients about the services they provided and acted on this to improve its services.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.

• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.

Patients told us that their treatment options and costs were explained to them. They also felt that their privacy and dignity were respected. Patients were able to book appointments at times convenient to them, and were seen promptly by dental staff when they arrived at the practice.

Patients were examined at the start of their treatment and appropriate records were kept of each appointment that included an initial assessment and medical history.

The practice operated in a clean and hygienic environment with well established processes to maintain the hygiene of treatment rooms and instruments between each patient and during the course of the day. The practice had suitable equipment to decontaminate used instruments and maintained a range of records relating to the cleaning of instruments and equipment. However, we found that in one week records relating to the bench top sterilizer had not been clearly dated.

Appropriate pre-employment checks were carried out on staff and a core training programme addressing medical emergencies, health and safety and infection control was in place for all staff.

The practice carried out regular health and safety and infection control audits and monitored the quality of service it provided to patients.