We carried out this announced inspection on 07 February 2019 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 Care Quality Commission (CQC) inspector who was supported by a specialist dental adviser.

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 not providing well-led care in accordance with the relevant regulations.

Background

Bridge Dental is in London Bridge, London. The practice provides private treatment to adults and children.

The dental team includes a practice manager who also undertakes receptionist duties, four dentists, a qualified dental nurse, a trainee dental nurse, a dental hygienist, a receptionist and a financial coordinator.

The practice has three treatment rooms.

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 the inspection, we collected four CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentist, the dental nurses, the dental hygienist, and the practice manager. We checked practice policies and procedures and other records about how the service is managed.

The practice is open at the following times:

Monday: 9.00am – 6.00pm

Tuesday: 8.00am – 6.00pm

Wednesday: 8.00am – 8.00pm

Thursday: 8.30am – 5.00pm

Friday: 8.30am – 5.00pm

Saturday: By Appointment Only

Our key findings were:

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider asked staff and patients for feedback about the services they provided. Feedback from patients was positive. Staff felt involved and supported and worked well as a team.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• The practice’s infection control arrangements required improvement in areas.
• The provider had completed recruitment checks for most staff, though some key checks had not been carried out.
• The practice had not carried out a Disability Access audit.
• The practice had ineffective systems to help them assess, monitor and manage risks relating to undertaking of the regulated activities at the time of this inspection, though they showed willingness to address the concerns we identified during the inspection.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulations the provider was not meeting are at the end of this report.

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

• Review the practice’s system for documentation of actions taken, and learning shared, in response to incidents with a view to preventing further occurrences and ensuring that improvements are made as a result.
• Review its responsibilities to respond to meet the needs of patients with disability and the requirements of the Equality Act 2010.