We carried out this announced inspection on 16 January 2019 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 Care Quality Commission 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

London Dental Studio is in the London Borough of Westminster. The practice provides predominantly private treatment to patients of all ages. The practice has a small contract to provide NHS dental treatments.

The practice is located across three floors. There are five treatment rooms, one of which is situated on the ground floor. Two treatment rooms are situated on the first and second floors of the building. The practice is located close to public transport bus and train services.

The dental team includes the principal dentist who owns the practice, six associate dentists who provide general dentistry, dental implants and orthodontic treatments and five dental nurses. The clinical team are supported by a practice manager / patient liaison manager, a treatment coordinator and three receptionists.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we received feedback from 25 patients.

During the inspection we spoke with the principal dentist, one dental nurse, the treatment coordinator and the patient liaison manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Monday to Friday between 9am and 6pm

Saturdays between 9am and 2pm.

Late appointments are available upon request.

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.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

We carried out an announced comprehensive inspection on 02 June 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

London Dental Studio is located in the London Borough of Westminster. The premises are situated in a two-storey building in a high-street location. There are five treatment rooms, a decontamination room, two X-ray rooms, two reception areas and patient toilets. These are distributed across the ground, first and second floors of the building.

The practice provides NHS and 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 specialist services such as implants, orthodontics and conscious sedation.

The staff structure of the practice consists of two principal dentists, three associate dentists, one hygienist, five dental nurses, a practice manager and five receptionists. There is also an endodontist and a specialist orthodontist.

The practice opening hours are Monday to Friday from 9.00am to 6.00pm. The practice is also open from 9.00am to 5.00pm on Saturdays.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual. Like registered providers, they are ‘registered persons’. 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 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, 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 staff team.

• There were arrangements for identifying, recording and managing risks through the use of risk assessment processes. However, we identified some areas where improvements were required.

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

• Review the systems for checking and monitoring equipment to ensure that all equipment is well maintained.
• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurences and ensuring that improvements are made as a result.
• Review the protocols and procedures for use of X-ray equipment giving due regard to Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.
• Review the practice's protocols for completion of dental care records giving due regard to guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s audit protocols, such as those for radiography, conscious sedation and dental care records, to help monitor and improve the quality of service. The practice should check audits, where applicable have documented learning points and the resulting improvements can be demonstrated.
• Review its responsibilities to the needs of people with a disability and the requirements of the equality Act 2010 and ensure a Disability Discrimination Act audit is undertaken for the premises.

People we spoke with said they received good information and the dentist discussed treatment options with them, which enabled them to make an informed choice. People said that they found the dentist to be friendly and approachable.

People we spoke with indicated that they were satisfied with the treatment provided by The London Dental Studio. People did not have any concerns or complaints and found the clinic to be clean and the staff friendly with a good professional manner. One person we spoke with said she had regained confidence after the treatment provided. Another person commented that a lot of detail goes into customer service.

People who use the service commented that the practice was clean and had observed that staff wear protective clothing.