We carried out this announced inspection on 24 October 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 (CQC) inspector who was supported by a specialist dental adviser.

We told the NHS England area team that we were inspecting the practice. They did not provide any information.

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

Elm Park Dental Surgery is located in Elm Park, in the London Borough of Havering. The practice provides NHS and private dental treatments to patients of all ages.

The practice is located on the ground and first floor of a purpose adapted residential premises. The practice has four treatment rooms, two of which are located on the ground floor. The practice is conveniently located close to public transport links.

The dental team includes two principal dentists and two associate dentists, two dental hygienists, two qualified dental nurses and two trainee dental nurses, two receptionists and a practice manager.

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.

We received feedback from 26 patients via CQC comment cards and speaking with patients. This information gave us a positive view of the practice.

During the inspection we spoke the one principal dentist and one associate dentist, one dental nurse and two trainee 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 Mondays, Wednesdays and Fridays, between 9am and 8pm on Tuesdays and Thursdays and between 9am and 1pm on Saturdays.

The practice is open between 1pm and 2pm for appointment bookings, new patient registrations and enquiries.

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance. Improvements were needed to ensure that these procedures were audited in line with this guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them assess and 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 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 current audit protocols to ensure audits of key aspects of service delivery such as infection prevention and control and radiography are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the dental radiographs and monitoring the quality of radiographs ensuring compliance with the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
• 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.

People we spoke with told us they were respected and treated well. They felt they were able to express their views and were involved in making decisions about their care and treatment. A person we spoke with said “they explain everything to me and they do explain costs before you sign the form.” Another person said “they give me plenty of information. I have had two teeth out and they have been brilliant.”

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. One person said, “sometimes I don’t see my usual dentist and see another one. They are all as good as each other and ask you the same questions.” We found that people received treatment at times which was suitable to them. A person told us “we can get an appointment when we need one and I always see the same dentist.”

People who uses the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse. There was a safeguarding policy in place for the protection of vulnerable children and adults. People said they felt safe and looked after when receiving care and treatment.

The provider had taken steps to ensure there were effective operation systems to assess the risk and control the spread of health care associated infection.

People had their comments and complaints listened to and acted on, without the fear they would be discriminated against for making a complaint. People we spoke with informed us that they were happy with the services they received. Comments we received included, “they are brilliant here,” “the dentists and the receptionists are so polite,” “I am really nervous about dentists, but they are really good. I have gone from nervous to being brave.”