We carried out this announced inspection on 12 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 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

Premier Dental Clinic is in Bromley, London and provides private treatment to adults and children.

There is level access for people who use wheelchairs, and those with pushchairs. Limited car parking spaces, including those for blue badge holders, are available near the practice.

The dental team includes a practice manager (who is also a qualified dental nurse), two dentists, two dental nurses, and a receptionist. The practice has two treatment rooms.

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 this inspection, we collected five CQC comment cards filled in by patients.

During the inspection we spoke with the dentists, the dental nurses, the practice manager, and the receptionist. We checked practice policies and procedures and other records about how the service is managed.

The practice is open at the following times:

Monday, Wednesday, Friday - 09:00 – 17:00

Tuesday, Thursday - 09:00 – 19:00

Saturday - By appointment only

Our key findings were:

• The practice appeared clean and well maintained.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk to patients and staff.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• 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 provider had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• The provider had infection control procedures, though there was no evidence they had carried out infection prevention and control audits.
• Dental care records were stored securely, clearly written and generally detailed, though some lacked information.

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 audit protocols to ensure infection control audits are undertaken at regular intervals, and where applicable learning points are documented and shared with all relevant staff.
• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.

We carried out an announced comprehensive inspection on 5 February 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

‏ Premier Dental Clinic is located in the London Borough of Bromley and provides private dental services. The practice specialises in dental implants and receives most of its patients via referrals from other dentists.

The staff structure of the practice comprises of one dentists, a dental nurse, a trainee dental nurse and a receptionist shared with another business located in the same building the practice is located in.

The practice was open 09.00 – 6.00pm Monday to Friday and Saturday by appointment.

Facilities within the practice include two treatment rooms, a dedicated decontamination room and a waiting area.

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.

Before the inspection we sent Care Quality Commission (CQC) comment cards to the practice for patients to complete to tell us about their experience of the practice. We received feedback from four patients. The feedback we received for patients gave a positive view of the services the practice provides. All of the patients commented that the quality of care was good.

We carried out an announced comprehensive inspection on 5 February 2016 as part of our planned inspection of all dental practices. The inspection took place over one day and was carried out by a lead inspector and a dental specialist adviser.

Our key findings were:

• There were effective processes in place to reduce and minimise the risk and spread of infection.
• Patients’ needs were assessed and care was planned in line with best practice guidance such as from the National Institute for Health and Care Excellence (NICE) and Delivering Better Oral Health.
• Patients were involved in their care and treatment planning.
• There was appropriate equipment for staff to undertake their duties and equipment was well maintained.
• Patients told us that staff were caring and treated them with dignity and respect.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• There were processes in place for patients to give their comments and feedback about the service including making complaints and compliments.
• Governance arrangements were in place and there was a clear vision for the smooth running of the practice.

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

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002, Regulations.

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• Review the practices’ current Legionella risk assessment and implement the required actions giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’
• 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 protocols for undertaking audits to ensure where appropriate audits have documented action plans and the identified learning is shared with staff to help improve the quality of the care.