We carried out this announced inspection on 13 December 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

P A Harris BDS Dental Surgery is in the London Borough of Ealing and provides NHS and private treatment to adults and children.

There is access for people who use wheelchairs and those with pushchairs. car parking spaces are available near the practice.

The dental team include a principal dentist, one hygienist, two dental nurses and a receptionist/practice manager

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 collected 58 CQC comment cards filled in by patients.

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

The practice is open:

• Monday and Wednesday 9am to 5pm

Tuesday, Thursday and Friday 9am to 1pm

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 provider 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• The appointment system took account of 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.

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

• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice's 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.

We spoke with the dentist, a dental nurse and three people using the service. The people we spoke with also told us that the dentist fully explained all treatment options with them and gave them all the information they needed before they were treated so that they could make an informed decision about their treatment. One person said “It's great here, she [the dentist] explains what choices I have and is very accommodating."

People were asked for their medical history at each visit to the dentist and people consented to the planned treatment. We observed positive interactions between the staff and people using the service. The people we spoke with were very complimentary about the service. One person said, "you get nothing but the best care here" and another person told us, "It's always really good here."

There were arrangements in place and appropriate equipment so that staff could respond promptly in the event of an emergency. The surgery room was clean, well maintained and uncluttered and there were effective systems in place to prevent and control the spread of infection.

There were adequate numbers of staff to ensure that peoples' needs were met effectively.

There was an effective system in place for managing complaints about the service.