We carried out this announced inspection on 26 July 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

Background

Harrow View Dental Surgery is in the London Borough of Harrow and provides NHS and private treatment to children and adults

The dental team includes the principal dentist, dentist/nurse and a receptionist.

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 collected 22 CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentist and the other dentist. We looked at practice policies and procedures and other records about how the service is managed.

• Monday 10am to 7pm
• Tuesday 9.30am to 6pm
• Thursday 9.30am to 7pm
• Friday 8.30am to 4pm

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 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 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.

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. However, the oxygen cylinder had not been maintained in line with current guidance, this was rectified immediately and the oxygen cylinder was replaced.

There were areas where the provider could make improvements. They should:

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).
• Review the systems for checking and monitoring electrical equipment taking into account current national guidance
• Review the practice's environmental risk assessments and ensure a fire risk assessment is undertaken and the necessary actions implemented.
• 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.

We spoke with three patients and two members of staff. All the patients we spoke with told us that they were involved in their treatment. Comments included, "They always show me what they are doing" and "They always explain everything". We found that patients were able to make decisions regarding their treatment and were treated respectfully.

Patients said they were happy with the treatment they received and that they would recommend the service. Comments included, "Its a very professional experience" and "The treatment is good here". We found that the provider made arrangements to ensure patients were treated safely.

The patients we spoke with told us they always found the premises and equipment clean and tidy. We found the premises were kept clean and equipment was either sterile or disposed of correctly.

We found equipment was well maintained. Equipment was also checked to ensure it was fit for use.

Staff were carefully recruited and checks kept up to date to ensure they were experienced and qualified to meet patients' needs.

Although none of the patients we spoke with said they had ever completed formal written feedback to the provider, they all said staff checked to ensure they were happy with their treatment. Comments included, "They always ensure I am happy before I leave". We found the provider checked to ensure it was meeting patient's needs.

The provider's records were stored and updated to ensure they were fit for purpose.