We carried out this unannounced inspection of Ivory Dental Clinic on 1 June 2017 under Section 60 of the Health and Social Care Act 2008. We undertook the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. A CQC inspector, who was supported by a dental adviser, led the inspection.

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

Ivory Dental Clinic is a well-established practice based in Welwyn Garden City centre that provides both NHS and private dentistry to patients of all ages. The dental team includes two dentists, two dental nurses, two hygienists and a practice manager. A dentist with a special interest in endodontics visits one a week, and there is also a visiting dentist who provides implants to patients.

The practice operates from the same premises as Ivory Dental and Implant Clinic and both share computer software, decontamination facilities, and a number of running costs, including utility bills. They also have a shared contract to provide NHS dental care.

The practice has three treatment rooms and is open on Mondays to Fridays between 9am and 5pm.

There is level access for people who use wheelchairs, ground floor treatment rooms and fully assisted toilet facilities.

The registered manager at Ivory Dental Clinic is the practice 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.

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

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• The practice did not have access to an automated external defibrillator and the medical oxygen available on the premises was out of date.
• 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 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 the practice's protocols for monitoring and recording the fridge temperature to ensure that medicines and dental care products are being stored in line with the manufacturer’s guidance.

• Review availability of medicines and equipment to manage medical emergencies taking into account guidelines issued by the British National Formulary, the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

• Review the protocols and procedures for use of X-ray equipment taking into account Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.