We carried out this announced inspection on 14 May 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.

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

Bupa Fulham Road Chelsea provides private and NHS treatment of all ages.

There is level access for people who use wheelchairs and those with pushchairs. The practice had nearby parking facilities.

The dental team includes nine dentists, four dental hygienists, four dental nurses, a receptionist, and one practice manager. The practice has three 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 manager and the current manager had completed the relevant forms to become the registered manager.

On the day of inspection, we collected seven CQC comment cards filled in by patients.

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

The practice is open:

• Monday to Friday 8.00am - 8.00pm
• Saturday 10.00am – 4.00pm
• Sunday 10.00am – 3.00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• 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.
• The practice had suitable information governance arrangements.

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

• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting taking into account the guidance issued by the General Dental Council.

We spoke with people using the service who told us that their treatment had been "fully explained" and that they "always discuss options" with the dentists. In recent patient feedback, when asked about staff being helpful and knowledgeable, and whether they received adequate information about their treatment the majority of people rated the practice as "very good".

People using the service described it as "very good" and said that medical histories were taken prior to treatment being provided. In recent patient feedback people said they were "very well looked after". Staff had been trained in what to do in a medical emergency. There were emergency drugs and equipment available in the practice.

On the day of the inspection the practice was clean and tidy. There were policies and procedures in place on how to maintain a clean and hygienic environment and staff made regular checks to ensure that these were being followed.

All staff underwent appropriate training on an annual basis in relevant mandatory topics such as medical emergencies and decontamination, as well as training specific to treatments they provided.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.