We carried out this announced inspection on 27 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

Quadrant Dental Care is in the London Borough of Harrow and provides NHS treatment to children and adults.

The dental team includes two principal dentists and three dental nurses.

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 27 CQC comment cards filled in by patients.

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

• Monday to Friday 9am to 5pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• 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.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. However, the oxygen cylinder had not been maintained in line with current guidance. This was rectified immediately and the oxygen cylinder was replaced.

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

• Review the practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.
• 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 protocols for referral of patients and ensure referrals are monitored suitably.

We spoke with one patient who was waiting for treatment during our visit to the service. They told us that they were happy that they had all the information they needed about their treatment. “The dentist gave me good explanations of the options for treatment and explained the fees. He spoke very clearly and was friendly.”

The latest analysis of patient satisfaction survey showed that 20 of the 34 people who returned surveys stated that they were very satisfied with all the services provided. Two people commented that they were dissatisfied with the choice of papers and magazines in the waiting room. This had been addressed, and a local information magazine was available. We noted that one person commented that they had no time to read magazines because they were always treated promptly.

People's needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. The patient records that we saw contained information on each treatment, and on the advice that was given.

People who use the service were protected from the risk of abuse. Staff were aware of their responsibilities for reporting any concerns about the safety and protection of children and vulnerable adults using the service.

There were effective systems in place to reduce the risk and spread of infection. The patient we spoke with told us that the surgery was always very clean and hygienic.