We carried out an announced comprehensive inspection on 07 October 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.

Background

Jivadental is located in the London Borough of Kingston-upon-Thames. The premises are situated in a high-street location. There are two treatment rooms, a decontamination room, an X-ray room, a reception room with waiting area, an administrative office, a staff room, two store rooms and patient toilets. These are situated on the first floors of the building.

The practice provides private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges. The practice also offers implants, endodontic treatments, and conscious sedation.

The staff structure of the practice consists of a principal dentist, two associate dentists, a hygienist a head dental nurse, a dental nurse and a practice manager. There is also a specialist implantologist who works at the practice, when required.

The practice opening hours are Monday to Wednesday from 9.00am to 5.00pm, Thursday from 10.00am to 7.00pm, Friday from 9.00am to 4.00pm and Saturday from 9.00am to 1.00pm.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered person. 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.

Thirty-four people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• There were effective systems in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• There were effective arrangements in place for managing medical emergencies.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

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

• 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.
• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review its current audit protocols to ensure audits of key aspects of service delivery are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
• Review its responsibilities to respond to the needs of patients with disability and the requirements of the Equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.

People using the service told us that they were satisfied with the treatment they had received and way it was provided. People said "I've always been very nervous about visiting the dentist but for every single visit I've made to Jivadental, I've become more and more relaxed". "The consultation was very thorough and my dental problems identified very efficiently". "It is like entering a dental oasis". Other people told us "The staff are very welcoming and adept at putting the customer at ease". "I was very impressed with the practice, very clean, tidy, well decorated with relaxing music and kind and friendly staff". People were also told about the cost of the treatment any risks that might arise from treatments chosen and asked to sign a consent form before treatment took place. People felt treated with dignity and respect by staff and confirmed they had received consultations and treatment in private.

They did not comment on the practice infection control systems and staffing numbers. They did tell us they thought the practice was kept clean, tidy and was well maintained and staff were very friendly, helpful and courteous. They were also aware of the complaints procedure.