We undertook a focused inspection of Lillywhite Dental Practice on 26 November 2018. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

We undertook a comprehensive inspection of Lillywhite Dental Practice on 17 May 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care in accordance with the relevant regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for Lillywhite dental practice on our website www.cqc.org.uk.

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

As part of this inspection we asked:

• Is it well-led?

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 17 May 2018.

Background

Lillywhite Dental Practice is in Morden and provides NHS and private treatment to adults and children.

The practice is on the second floor of a medical centre. There is level access via a lift for people who use wheelchairs and those with pushchairs. There is non-restricted parking in surrounding roads.

The dental team includes three dentists, one dental nurse, one trainee dental nurse one dental hygienist and two receptionists. The practice has two treatment rooms.

The practice is owned by a partnership 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 Lillywhite Dental Practice is one of the principal dentists.

During the inspection we spoke with the principal dentists and one of the dental nurses. We looked at practice policies and procedures and other records about how the service is managed.

Our key findings were:

• The provider had appropriate systems for monitoring equipment, and ensuring they were maintained in line with manufacturers guidance.

• The provider had established systems to ensure good governance in accordance with the fundamental standards

We carried out this announced inspection on 17 May 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 not providing well-led care in accordance with the relevant regulations.

Background

Lillywhite Dental Practice is in Morden and provides NHS and private treatment to patients of all ages.

The practice is on the second floor of a medical centre. There is level access via a lift for people who use wheelchairs and those with pushchairs. There is non-restricted parking in surrounding roads.

The dental team includes three dentists, a dental hygienist, a dental nurse (who performs a dual role as receptionist), a trainee dental nurse and two receptionists The practice has two treatment rooms and a separate decontamination room.

The practice is owned by a partnership 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 Lillywhite Dental Practice was one of the principal dentists.

On the day of inspection we collected feedback from 27 patients through comment cards and speaking with people.

During the inspection we spoke with one of the dentists, the dental nurse, one of the receptionists and the trainee dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Friday from 9.00am to 6.00pm

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 as per national guidance was not available.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. Evidence of training though was not made available to us.
• 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.
• 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 did not have effective systems and processes to ensure good governance

We identified regulations the provider was not meeting. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation/s the provider was/is not meeting are at the end of this report.

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

• Review the practice's systems for checking and monitoring equipment taking into account relevant guidance and ensure that all equipment is well maintained.