We carried out this announced inspection on 3 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

Ham Dental Practice is in Kingston Upon Thames and provides NHS and private treatment to patients of all ages.

The practice has its own on-site car park.

The dental team includes four dentists, three dental nurses, one dental hygienist, one receptionist and one practice manager. The practice has five 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 received feedback from 13 patients.

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

The practice is open:

• Monday to Thursday 9:00am to 5:30pm
• Friday 9.00am to 1:00pm

Our key findings were:

• Some areas of the practice appeared clean and well maintained.
• The practice had some infection control procedures that 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; however, they did not always retain comprehensive notes of all discussions that took place.
• 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 a culture of continuous improvement.
• Staff felt involved, 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 infection control procedures and protocols taking into account the guidelines issued by the Department of Health in the Health Technical Memorandum 01-05: Decontamination in primary care dental practices, and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.

• Review the practice’s testing protocols for equipment used for cleaning used dental instruments taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and having regard to The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.
• Review the practice’s systems in place for environmental cleaning taking into account guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices.
• 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.

Ham Dental Practice provided general, cosmetic and preventative dentistry. During our visit we spoke with three people who used the service. People we spoke with told us that they were provided with enough information about available treatment options. They told us that options were discussed with them by the dentist and that there were able to ask questions. One person said, “Everything is fully explained”.

We saw that there were arrangements in place to deal with foreseeable emergencies and that infection and prevention control procedures were followed to minimise the risk of cross infection. People we spoke with told us they were happy with the treatment they received and the way it was delivered. One person said, “Very accommodating and competent staff”. Dental staff were registered with the General Dental Council (GDC) and were required to complete continuous professional development modules to maintain their registration

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others. Records demonstrated that the practice carried out yearly audits and maintenance of dental equipment including X-ray and sterilisation machines.