We carried out this announced inspection on 18 January 2019 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.

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

Heffernan Dental Specialists is in the London Borough of Westminster. The practice provides private treatment to patients of all ages including dental implants, specialist prosthodontic and endodontic treatments and treatments using conscious sedation techniques.

The practice is located on the third floor of the premises and there is step free access the practice via a passenger elevator. The practice is located close to public transport bus and train services.

The dental team includes the principal dentist who own the practice, one associate dentist who provides specialist endodontic treatments, three dental hygienists and two dental nurses. The clinical team are supported by a practice manager.

The practice is owned by a company 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 Heffernan Dental Specialists was the principal dentist.

On the day of inspection we received feedback from 30 patients.

During the inspection we spoke with f the principal dentist, the associate dentist, one dental nurse, one dental hygienist 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 8.30am and 5.45pm on Mondays to Fridays:

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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 with the exception of some medicines which were ordered and received promptly. The practice had shared use of an automated external defibrillator which was available for use within the building. Consideration should be given to potential risks with these arrangements.
• 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.
• 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.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

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

• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team. This relates specifically to the arrangements in place and the shared use of an automated external defibrillator.

• Review the practice’s protocols for conscious sedation, taking into account guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015. This relates specifically to ensuring the completeness of dental records in relation to the assessments and checks carried out before, during and after treatment using conscious sedation.