We carried out this announced inspection on 10 December 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

Enfield Dental practice is in the London Borough of Enfield and provides NHS and private treatment to adults and children.

There is access for people who use wheelchairs and those with pushchairs. car parking spaces are available near the practice.

The dental team includes two principal dentists, 12 associate dentists, one hygienist, 10 dental nurses, two receptionists and a practice manager

The practice is owned by a Partnership 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 Enfield Dental Practice was the practice manager.

On the day of inspection, we collected 14 CQC comment cards filled in by patients.

During the inspection we spoke with the registered manager, both principal dentists, four associate dentists, four 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:

• Monday to Friday 9.15am to 6pm

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 provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of patients’ needs.
• The practice had effective leadership and a 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.

Patients told us that treatment was explained to them by staff in the surgery in private, that they were given choices of treatment, costs, were able to express their views and were involved in making decisions about their care and treatment. One patient told us that "the dentist was very good and explained everything".

We spoke with staff and saw records that showed care and treatment was planned and delivered in line with their individual treatment plan. Patients were recalled at intervals based on their individual needs. One relative said "I really liked the way the dentist treated my child."

We saw that the provider had patient safety and child protection policies and procedures. Staff were aware of this and knew to report any allegations of abuse to the manager, the local authority and police as necessary.

The premises were clean and well maintained. The provider told us and we saw that refurbishment works were in progress to provide upgraded reception areas, decontamination room and separate plant room. We saw that audits had been carried out by the provider to monitor infection control guidelines as detailed in Department of Health Technical Memorandum 01-05 (HTM 01- 05).

We saw that patients' personal records including medical records were stored securely and were kept up to date. Records were stored in accordance with the Data Protection Act 1998 (DPA 98) but the provider may like to note that they were not retained in accordance with DPA 98.