We carried out this announced inspection on 14 February 2018, 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 and Healthwatch that we were inspecting the practice. , they they did not provide any information that 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

Bridge Dental Centre is in Richmond and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs.

The dental team includes five dentists, four dental nurses, four dental hygienists, two receptionists and one practice manger. The practice has four treatment rooms.

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 was the clinical director.

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 received feedback from 15 patients. This information gave us a positive view of the practice.

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

The practice is open:

• Monday: 9:00am to 6:00pm

• Tuesday: 8:00am to 5:00pm

• Wednesday: 8:00am to 5:00pm

• Thursday: 8:00am to 7:00pm

• Friday: 8:00am to 5:00pm

• Saturday: 9:00am to 1:00pm

Our key findings were:

• The practice was appeared clean and well maintained.
• The practice had infection control procedures that 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, 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.

People who attended the dental centre told us they were satisfied with the service and treatment they received and way it was provided. People said "A lovely dentist and nurse". "One of my children has gone from being seriously paranoid to very calm". "Once treated by my dentist my problems disappeared".

People told us they had the consultation procedure, available treatments and costs clearly explained to them. This included any risks attached to the treatments. They said they were treated with dignity and respect by staff and felt safe using the centre.

They did not comment on the practice infection control systems in place or number of staff available to meet their needs. They did tell us they thought the centre was kept clean and tidy. They did say "Everyone is nice and friendly".

People using the service were also aware of the complaints procedure and how to use it.

We saw that staff were professional, knowledgeable and gave information to people using the service in a clear and easy to understand way that included the cost of any treatment. There were enough suitably qualified staff to meet the treatment and needs of people using the service in a competent, efficient and friendly manner.

The centre was clean and there were effective infection and cross contamination control systems in place. Records were kept up to date and there was a complaints procedure that was available to people using the service.

During our visit we spoke with people who use the service. They were positive about their experience and felt the staff were welcoming and made them feel relaxed. They said that they felt involved in their treatment and that this was explained to them in a way they understood. People said they felt able to ask questions about their treatment to ensure they knew what to expect. They said the surgery was clean and that they had no concerns about the cleanliness of the practice.

We saw staff interacting with the people who used the service, where they were friendly and professional towards them.