We carried out an announced comprehensive inspection on 20 January 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.

Holloway Dental Centre is located in the London Borough of Islington. The practice is on the second floor and comprises of five surgeries and a decontamination room. There is also a reception and waiting area. Toilet facilities and a staff area where also available.

The practice provides NHS and private dental services and treats both adults and children. The practice offers a range of dental services including routine examinations and treatment.

The staff structure of the practice comprises of a principal dentist, five associate dentists, one dentist with practice limited to orthodontics, five dental nurses, two receptionists, a hygienist and practice manager. The practice was open Monday to Friday from 9am-5.30pm and alternate Saturdays from 9am-2.30pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. 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 inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

We received feedback from 22 patients. The feedback from the patients was positive in relation to the care they received from the practice. They were complimentary about the friendly and caring attitude of the staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with best practice guidance, such as from the National Institute for Health and Care Excellence (NICE).
• The practice had systems in place to minimise the risks associated with providing dental services.
• The practice had policies and procedures in place for child protection and safeguarding adults.
• Equipment, such as the air compressor, autoclave (steriliser), and dental chair had all been checked for effectiveness and had been regularly serviced.
• There were systems in place to reduce the risk and spread of infection.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and patient practice team.
• There were arrangements in place to deal with foreseeable emergencies
• There was a complaints procedure available for patients.
• The practice had a clear management structure and governance arrangements were in place for the smooth running of the practice.

There were areas where the provider could make improvements and should:

• Review its audit protocol for X-rays. Practice should ensure all audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practice’s arrangements for sharing and learning from safety alerts.
• Review the practice's recruitment policy and procedures in line with Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 to ensure necessary employment checks are in place for all staff and the required specified information in respect of persons employed by the practice is held.
• Review availability of equipment to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’ especially in regard to use of saline during oral surgery.

We visited the practice over the course of an afternoon on the 20th March 2012. We spoke with patients and staff and examined records relating to the treatment of patients and management of the practice.

Patients told us that their treatment options and costs were explained to them. They also felt that their privacy and dignity were respected. Patients were able to book appointments at times convenient to them, and were seen promptly by dental staff when they arrived at the practice.

Patients were examined at the start of their treatment and appropriate records were kept of each appointment that included an initial assessment and medical history.

The practice operated in a clean and hygienic environment with well established processes to maintain the hygiene of treatment rooms and instruments between each patient and during the course of the day. The practice had suitable equipment to decontaminate used instruments and maintained a range of records relating to the

cleaning of instruments and equipment. We found that some minor maintenance was needed in the decontamination room to address potential infection control risks.

Appropriate pre-employment checks were carried out on staff and a core training programme addressing medical emergencies, health and safety and infection control was in place for all staff.

The practice carried out regular audits and monitored the quality of service it provided to patients.