We carried out this announced inspection on 3 August 2017 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. NHS England provided information which 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

Castle Dental Practice is located in Dagenham in the London Borough of Barking and Dagenham and provides predominantly NHS and some private dental treatment to patients of all ages.

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

The dental team includes the principal dentist, one trainee dental nurse, one receptionist and an acting practice manager. The practice has two 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 inspection we collected 35 CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice.

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

The practice is open between 8am and 6pm on Mondays, Tuesdays and Thursdays and 8am to 1pm on Wednesdays and Fridays.

Our key findings were:

• The practice was 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 appointment system met patients’ needs.
• The practice had effective leadership. 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.

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

• Review the practice’s systems for analysing the results of audits and reviews to identify, share and act on areas for improvement where appropriate.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray ensuring compliance with the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.

People who used this dental practice told us they were pleased with the quality of the service provided. They felt they were treated respectfully and that treatments were clearly explained to them. One person said “I was terrified of the dentist until a few years ago when I came here. They were very reassuring and explained everything.” Another told us “they explain things nicely and clearly and are always polite and friendly.”

People’s care and welfare needs were met and systems were in place to treat those in pain or in need of urgent treatment. We saw several letters of thanks from patients. One person said “thank you for staying behind to help me the other day.” Another had written “thank you for always doing a great job. I have every confidence in you.”

Staff received the training and support they needed to provide a safe and appropriate service that met people’s care and welfare needs. The provider monitored and assessed staff work practice to ensure they were carrying out their duties correctly and safely.

The service rarely received any complaints but information was available in the surgery and in the patient information leaflet to advise people of their options if they were not satisfied with the service provide.

Systems were in place to ensure that people were treated in a safe, clean and hygienic environment.