We carried out this announced inspection on 2 May 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

East Street Dental Practice is in Barking in the London Borough of Barking and Dagenham and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs.

The dental team includes five dentists, two dental hygienists, five dental nurses, three receptionists and a practice manager. The practice has four 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 East Street Dental practice was the practice manager

On the day of inspection we received feedback from 20 patients.

During the inspection we spoke with three dentists, two dental nurses one 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 between 9am and 6pm on Monday to Saturday.

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 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.

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 by the Medicines and Healthcare products Regulatory Agency, the Central Alerting System and other relevant bodies, such as Public Health England.
• Review the practice's protocols for monitoring and following up on referrals made to specialists in primary and secondary care to ensure that patients were seen in a timely manner.

People told us that they were treated with respect by staff at the service. One person said "they were professional, very polite." People told us that treatment options were explained to them, and that they were made aware of any fees they were liable to pay. People told us that discussions about treatments were held in private, and we saw the layout and design of the building facilitated private discussions.

We saw that treatment plans were in place for people. These were signed to indicate people gave consent to treatment. The service took details of the medical histories of people before providing treatment to them. People told us that they found the environment to be clean, and that staff wore protective clothing. One person said "it was very clean" and "the dentist wore a mask, gloves and glasses." We observed that the service was visibly clean, and staff told us of infection control procedures in the service. We saw records that showed regular cleaning of the service. Staff demonstrated their procedures for decontaminating and sterilising dental equipment.

We found that staff had regular training, including in dealing with medical emergencies and infection control. People told us they knew how to make complaints, and we found complaints procedures to be in place.