We carried out this announced inspection on 5 July 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 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

Confident Dental Practice is in Kings Cross, in the London Borough of Camden. It provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Restricted car parking spaces, including those for disabled badge holders, are available near the practice.

The dental team includes three dentists, two dental nurses, a trainee dental nurse, a dental hygienist, two receptionists who are also dental nurses, and a practice manager. The practice has two treatment rooms located on the ground and lower ground floor of the premises.

The practice is owned by a company, and as a condition of registration must have a person registered with the Care Quality Commission (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 Confident Dental Practice was the principal dentist.

On the day of inspection we collected feedback from 33 patients. This information gave us a positive view of the practice.

During the inspection we spoke with the practice manager, the principal dentist, an associate dentist, three dental nurses, and a receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open from 9am to 5.45pm every Monday to Friday.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• 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.
• 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.
• The practice had staff recruitment procedures.
• The practice had effective leadership. Staff felt involved and supported and worked well as a team.
• Staff knew how to deal with emergencies. Improvements were needed to ensure some life-saving equipment was available. Improvements were also needed to ensure incidents were recorded.
• The majority of clinical staff provided patients’ care and treatment in line with current guidelines, though improvements were needed to ensure the necessary information was recorded in all dental care records.

Shortly after the inspection the practice took steps to address the issues identified.

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

• Review the practice’s system for documentation of incidents that occur, actions taken, and learning shared, with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.