We carried out an announced comprehensive inspection on 8 December 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Garden Square Dental Practice located in Westminster London, provides private dental treatment to patients of all ages. The practice also provides conscious sedation and minor oral surgery services. [Conscious sedation – procedure using a combination of medicines to help a patient to relax (a sedative) and to block pain (an anaesthetic) during a medical or dental procedure. The patient remains awake during the whole procedure.}

Practice staffing consists of the two principal dentists, specialist prosthodontist, periodontist, oral surgeon, two hygienists, one dental nurse and one business development manager/dental nurse.

One of the principal dentists is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 practice is open Monday to Thursday 8am to 5.30pm, Tuesday 8am to 8pm, Friday 9am to 5.30pm and Saturday 9am to 4pm.

The practice facilities include two treatment rooms, a reception and waiting area, decontamination room, large office and staff room/kitchen.

20 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received about the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• The practice was visibly clean and clutter free there were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• Conscious sedation was delivered safely in accordance with current guidelines.
• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.
• The practice sought feedback from patients about the services they provided and acted on this to improve its services.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.

People who use the service were given appropriate information and support regarding their care or treatment. The provider’s website published information, for example, how they could be contacted, the treatments offered and the cost of fees for consultations and treatments.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People’s dental needs were assessed before any treatment was planned.

People were treated in an environment that was clean and hygienic. When asked about the overall cleanliness of the practice one person told us they thought it was ‘’excellent, no concerns whatsoever.’’

Staff received appropriate professional development. All staff carried out training relevant to their practice.

The provider had systems to identify, assess and manage risks to health, safety and welfare of people using the service. A patient record audit had been completed in June 2013. Inconsistencies identified had been addressed with an action plan.