We carried out an announced comprehensive inspection on 23 September 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 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

The practice is situated in the London Borough of Tower Hamlets. The premises are laid out over three floors with two treatment rooms, two dedicated decontamination rooms, a waiting room with reception area, staff room, storage rooms and bathrooms.

The practice provides NHS and private dental services for adults and children. The practice offers a range of dental services including routine examinations and treatment, as well as some restorative and orthodontic treatment.

There are five dentists working at the practice, one qualified and three trainee dental nurses, a full time practice manager and a full time receptionist. There is also a hygienist available at the practice on one day per week. There are two treatment rooms in use at the practice.

The practice is open between 9:00am and 5:00pm Monday to Friday. Appointments are from 9:00am to 1:00pm and from 2:00pm to 5:00pm.

The principal dentist was the registered manager at the time of the inspection. A registered manager is a person who is registered with the CQC 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 Care Quality Commission (CQC) inspector and a dentist specialist advisor.

As part of our inspection we asked for CQC comment cards to be completed by patients prior to our inspection. We also spoke with patients on the day, and received feedback from twelve patients in total, who were all positive about the standard of care received, emphasising the caring attitude of all staff.

Our key findings were:

• There was a procedure for reporting incidents, and the practice learnt from incidents and complaints.

• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.

• There were systems in place to decontaminate equipment, and reduce and minimise the risk and spread of infection. However, the practice had not carried out an infection control audit for two years.

• There were systems in place to dispose of waste appropriately. However, the practice was not storing used amalgam capsules in a safe manner.

• Staff were trained in basic life support, and understood how to act in an emergency situation. The practice had emergency medicines, oxygen and an automated external defibrillator (AED).

• Dental care records and prescription pads were stored securely, though improvements could be made in the storage of prescription pads.

• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.

• 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).

• Patients indicated that they felt they were informed about the treatment options available to them, and that they received good care.

• The practice received patient feedback, however did not have any systems in place to review this feedback or introduce improvements in response.

• The practice had carried out recent audits to review and improve the quality and safety of the services.

• The practice manager had a clear vision for the practice and staff told us they were well supported by the management team.

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

• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Review the storage of used amalgam capsules to ensure they are stored safely before disposal.

• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the use of disposable cleaning equipment, including disposable mop heads, and introduce a system to review the standard of cleaning carried out.

• Review its audit protocols to ensure infection control audits are undertaken at regular intervals and learning points are documented and shared with all relevant staff.

• Consider implementing a system to review patient feedback and introduce improvements.