We carried out this announced inspection on 22 September 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 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 providing well-led care in accordance with the relevant regulations.

Background

CBC Dental Studio is in Canada Water, in the London borough of Southwark. It provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Restricted car parking spaces are available near the practice.

The dental team includes seven dentists, a dental nurse, two trainee dental nurses, a dental hygienist, two dental administrators who also work as receptionists, and a domestic staff member. The practice has two treatment rooms.

The practice is owned by a company, and as a condition of registration must have a person registered with the CQC 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 at CBC Dental Studio was the practice manager.

On the day of inspection we received feedback from 10 patients This information gave us a positive view of the practice.

During the inspection we spoke with the principal dentist, the dental nurses, a dental administrator/ receptionist 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, Tuesday: 9am – 8pm

Wednesday, Thursday: 9am – 6pm

Friday: 8am – 4pm

Saturday: 9am – 4pm

Our key findings were:

• The practice was clean and well maintained. They had infection control procedures which reflected published guidance.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• Staff knew how to deal with emergencies. Emergency medicines and equipment were available in line with national recommendations.
• The practice had systems to help them manage risk. The practice carried out an outstanding health and safety risk assessment shortly after the inspection.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• The team kept clearly written patient dental care records which stored securely. Improvements could be made to ensure all dentists recorded the necessary information in patients’ dental care records with regard to radiographs taken.
• Staff knew their roles and responsibilities, though improvements could be made to ensure all clinical staff had a good understanding of the Mental Capacity Act and Gillick competence.
• Staff told us they received regular appraisals; improvements could be made to ensure these appraisals were documented.
• Improvements could also be made to the practice’s recruitment procedures with regard to ensuring specific background checks were carried out prior to staff commencing work at the practice.

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

• Review staff awareness of their responsibilities with regard to the Mental Capacity Act 2005 and Gillick competence.
• Review staff supervision protocols to ensure an effective process is established for the on-going appraisal of all staff.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the radiograph and quality of the radiograph, ensuring compliance with the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
• Review the practice’s recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.

Shortly after the inspection the practice proactively began to address issues we had identified and sent us evidence of actions they had taken within two days of the inspection.