We carried out this announced inspection on 2 August 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

Chiswick Dental Care Limited - London is in the London Borough of Hounslow and provides NHS and private treatment to adults and children.

The practice is set out over one level and there is level access for people who use wheelchairs and those with pushchairs.

The dental team includes three dentists, one dental nurse, two trainee dental nurses and a practice manager. The practice manager and one of the dental nurse also cover reception duties. 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 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 at Chiswick Dental Care Limited was the principal dentist.

On the day of inspection, we collected 43 CQC comment cards filled in by patients.

During the inspection we spoke with two dentists and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday 9.00am to 5.00pm.

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 staff 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 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.

During the inspection we talked with two people using the service and two members of staff to get their views about the service that is provided by the practice.

People’s feedback showed that they were very pleased with the service they received. They all said the dentists took the time to explain their condition, treatment options and the costs so that they had all the necessary information to make informed decisions. One person said “the dentist explained your problem and the treatment so you can make a decision”. Another person reported “my treatment has occurred with a minimum of pain and discomfort”.

The practice provided care and treatment to a range of people, including people who were from ethnic minorities and those who were wheelchair users. People confirmed that their privacy was respected, whilst they received treatment. They agreed that the practice was clean and maintained appropriately.

We found that the practice had effective governance arrangements to monitor and to provide information about the quality of the service people received. These included arrangements to encourage people to express their views about the quality of the service. Where areas for improvement had been identified, the manager had action plans in place to ensure improvement of the service.