We carried out this short-announced inspection on 16 April 2019 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

Dentalessence Weybridge is in Oatlands Village and provides NHS and private treatment to adults and children.

Currently the service is registered for 'management of supply of blood and blood derived products'. The provider confirmed that they have never provided this regulated activity and confirmed they will be removing this from their registration.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces on the road, are available near the practice.

The dental team includes 5 dentists, 4 dental nurses, 1 dental hygienists,1 practice manager and 2 receptionists. The practice has 3 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.

During the inspection we spoke with 3 dentists, 1 dental nurse, 1 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: 08.00-17.00 Monday to Friday

Our key findings were:

• The practice appeared clean and well maintained.
• The provider 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 to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.

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

• Review the practice's recruitment procedures to ensure that appropriate checks are completed prior to new staff commencing employment at the practice.
• Review the practice's protocols and procedures to ensure staff are up to date with their mandatory training and their continuing professional development[RJ1].
• Review the practice's current performance review systems and have an effective process established for the on-going assessment and supervision of all staff.
• Review the practice's risk management systems for monitoring and mitigating the various risks arising from the undertaking of the regulated activities.[RJ2][RJ3]
• Review the practice’s protocols to ensure audits of radiography and infection prevention and control are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practice’s arrangements for ensuring good governance and leadership are sustained in the longer term.[RJ4]
• Review the practice's responsibilities to take into account the needs of patients with disabilities and to comply with the requirements of the Equality Act 2010. [RJ5]
• Review the practice’s protocols for the use of closed circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.

During our visit we saw that patients were treated with dignity and respect by all of the staff and the dentists. Patients we spoke with told us that they felt involved with their dental care and were happy with their treatment.

On the day of our visit we observed a new patient receiving a consultation. We saw that the dentist carried out an examination, explained what they found and gave options to the patient about what treatment was available.

We saw six patient records and noted that the dentists had recorded what had been discussed at each visit and that each patient had signed to say that they agreed with their treatment plan.

We asked patients if they felt safe at Oatlands Dental Care and they told us that did feel safe. We saw leaflets and posters displayed in the reception area informing patients what they could do if they had any concerns about their safety.

We saw that the dental practice was clean and tidy and that there were effective infection control systems in place to monitor the cleaning of the premises and equipment.