We carried out this announced inspection on 7 November 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.

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

Dr Fazeela Khan-Osborne

is located in Westminster and provides private specialist implant and general dentistry treatment to patients of all ages.

There is access for people who use wheelchairs via ramped access.

The dental team includes two dentists, three dental nurses, a dental hygienist and receptionist. The practice has three 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 34 CQC comment cards filled in by patients and spoke with three other patients. This information gave us a positive view of the practice.

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

The practice is open Monday to Friday. 9.00 am.-5.30pm.

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. However improvements could be made in regards to how safeguarding policies addressed vulnerable adults.
• The practice had staff recruitment procedures; however improvements could be made to these 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 areas where the provider could make improvements. They should:

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review the practice's current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.

• Review the practice’s safeguarding policy ensuring it covers both children and adults. Staff are trained to an appropriate level for their role and are aware of their responsibilities.

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

We spoke with people who used the service and looked at feedback forms that had been completed in December 2012 and January 2013. People had been given sufficient information and felt that the treatment required had been explained clearly. One person described their dental surgeon as "the most caring and professional dentist I have ever had". People were cared for in a clean and hygienic environment and by staff that had received appropriate professional development. Dental nurses were appraised once they had completed a six month probationary period. There was an induction checklist in place and mandatory training had been scheduled.

Care and treatment was planned in a way to ensure their welfare and safety. People were required to complete a medical history form and if sedation was required, they were monitored before, during and after the procedure by a dedicated member of staff. There were arrangements in place to deal with foreseeable emergencies. There was emergency equipment available and staff had received basic life support training.

Instruments were decontaminated appropriately. There were systems in place to protect people from the risk of infection and to monitor the quality of service people received. Audits had been carried out in relation to records, patient feedback and x-rays, but there had been no audits undertaken in relation to infection control. People were asked for their feedback and this was discussed at practice meetings.