We carried out this announced inspection on 19 December 2017 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

iDental - The Medical Centre is located in Shepherds Bush and provides general and orthodontic private treatment to patients of all ages.

There is access for people who use wheelchairs and those with pushchairs.

The dental team includes a dentist, two dental nurses and a practice manager. The practice has one treatment room.

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 iDental - The Medical Centre was the principal dentist.

On the day of inspection we collected 33 CQC comment cards filled in by patients and spoke with three other patients. This information gave us a positive view of the practice.

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

The practice is open Monday to Friday 9.00am to 7pm and Saturdays 8.00am to 8.00pm

Our key findings were:

• The practice was generally clean and tidy on the day of the inspection.
• The practice had infection control procedures which generally reflected published guidance, although improvements were required.
• Staff knew how to deal with emergencies and most of the recommended medicines and life-saving equipment were available, although there were some gaps.
• The practice had systems to help them manage risk.
• The practice had safeguarding processes in place but improvements were required
• The practice had staff recruitment procedures but improvements were required
• 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 appointment system met patients’ needs.
• 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.

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

• Review practice's safeguarding policy and ensure the policy refers to both adult and children.
• Review the practice’s system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.
• 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.

• 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 practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

We were unable to speak to people at this inspection as there were no appointments made. We looked at the returned quality assurance questionnaires completed by people who had received treatment from the practice. People said that they were satisfied with the care and treatment they received. They felt that they had been given sufficient information about their care and treatment. One person commented that they were “extremely happy” with the treatment and described staff as “experienced and professional”.

A detailed medical history was taken from each person and any allergies or medical conditions were recorded and discussed during the initial appointment. People were given aftercare advice following treatment, which included an emergency telephone number. There was emergency equipment available and all staff had received basic life support training.

There was a procedure in place to ensure that staff were able to identify and respond appropriately to abuse children. There was no policy or procedure in place for the safeguarding of vulnerable adults.

There were effective systems in place to reduce the risk of infection. Staff were able to describe the decontamination process to us and provided evidence to show that checks were carried out on the equipment used.

There were effective systems in place to monitor the quality of the service. Staff meetings took place on a monthly basis to discuss the feedback that people had provided.