We carried out this announced inspection on 12 July 2018 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

Khiroya Dentist - Harrow is in the London Borough of Harrow and provides NHS and private treatment to adults and children.

The dental team includes a principal dentist, three dentists, a foundation dentist, three dental nurses, one hygienist and a receptionist

The practice is owned by an organisation 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 Khiroya Dentist – Harrow was the principal dentist.

On the day of inspection, we collected 36 CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentist, one dentist, the foundation dentist, two dental nurses, and the receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday to Friday 8.30am to 5.30pm

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.
• 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 and a culture of continuous improvement.
• 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.
• The practice had suitable information governance arrangements.

We spoke with three people who use the service and seven members of staff including dentists, dental nurses and a receptionist. We also observed two consultations.

People who use the service told us they were happy with their care and treatment. They said that they received advice regarding their oral health and the dentist explained any treatment during their consultation. The provider had equipment and training to deal with foreseeable emergencies.

Although people who use the service did not have any concerns regarding the care and treatment they received, we found that the provider had not received enough training and staff were not always aware of their legal responsibilities regarding safeguarding children or vulnerable adults.

Everyone we spoke with told us they found the service clean, tidy and hygienic. One person said, "They definitely have safety and welfare in mind." The provider undertook infection control processes to ensure both the premises and the equipment were clean and sterile.

The people who use the service told us that they felt the staff were trained and qualified to provide the care and treatment they required. We saw evidence that staff were checked to ensure they were eligible and safe to work with children and vulnerable adults. However there was no evidence of how staff were recruited.