We carried out this announced inspection on 11 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

Sovereign House Specialist Dental Centre is in Brentwood, Essex and is a private specialist dental practice; their services include dental implants, dental implant solutions, oral surgery, maxillofacial Surgery, sedation services and some children's dentistry. The practice provides private orthodontic treatments. The practice also provides a tongue tie release service.

The practice is situated on the first floor. Car parking spaces, including spaces for blue badge holders, are available in local car parks near the practice. Patients who require wheelchair access are referred to one of two sister practices with level access.

The dental team includes nine dentists; whose specialisms include Periodontics, Endodontics, Orthodontics, Oral Surgery and Maxillofacial Surgery. They are supported by two hygienists, four dental nurses, two receptionists and one practice manager. The practice has three treatment rooms.

The practice is owned by a company 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 Sovereign House Specialist Dental Centre is the principal dentist.

On the day of inspection, we collected 27 CQC comment cards filled in by patients and spoke with one other patient.

During the inspection we spoke with one dentist, two dental nurses, one receptionist 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 to Friday from 9am to 5.30pm and Wednesday from 9am to 6.30pm. We were told the practice often opened at weekends to accommodate urgent appointments.

Our key findings were:

• Effective leadership was provided by the principal dentist and an empowered practice management team.
• Staff we spoke with felt well supported by the principal dentist and practice manager and were committed to providing a quality service to their patients by ensuring their patients were their main priority.
• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Emergency equipment and medicines were mostly available as described in recognised guidance. There was no size 4 airway and the size 4 clear face mask was also missing. There was no buccal midazolam available, a medicine used to treat a number of conditions including seizures. The practice confirmed these had been purchased following the inspection.
• The practice had systems to help them manage risk.
• The practice staff had embedded 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 culture of continuous improvement. Staff felt involved and supported and worked well as a team.
• The practice staff dealt with complaints positively and efficiently.
• The practice had a strong culture of continuous improvement and development.
• The practice asked staff and patients for feedback about the services they provided. Results of feedback were analysed and discussed at staff meetings to share learning. We noted feedback from patients and other clinical professionals was wholly positive.

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

• Review the availability of equipment in the practice to manage medical emergencies taking into account the guidelines issued by the Resuscitation Council (UK) and the General Dental Council.