We carried out this announced inspection on 25 September 2017 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

Ten Dental is located in Clapham and provides private treatment to patients of all ages.

There is access for people who use wheelchairs and those with pushchairs.

The dental team includes 10 dentists, five dental nurses, a dental hygienist and two receptionists. The provider, clinical director, and area manager were also present on the day of the inspection. 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 Ten Dental was the clinical director.

On the day of inspection we collected 40 CQC comment cards filled in by patients and spoke with three other patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, a dental nurse two receptionists and the area manager and the provider clinical director. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open 08.00am – 20.00pm Monday to Thursday, 0.800 am – 17.30pm Fridays and 10.00am to 16.00pm on Saturdays. The practice were in the process of trailing Sunday openings and had opened on a Sunday for the first time on the Sunday before the inspection.

Our key findings were:

• The practice was 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 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 dealt with complaints positively and efficiently.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available. Improvements could be made to ensure all medicines and equipment were stored safely.
• Improvements could be made to ensure radiography audits were more comprehensive with regard to identifying and sharing learning with individual dentists.

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

• Review the practice’s protocols for medicines management and ensure all medicines are dispensed and stored safely and securely.

• Review the practice’s systems for undertaking audits with a view to ensuring all identified objectives and recommendations can be shared with all relevant staff.

People using the service told us they were very satisfied with the practice, service they received and way it was provided. One person told us "Great balance between warm, genuine customer service and reliable, solid and trusted work". Another said "No stress dental visits and spot on advice with a friendly atmosphere". They were given explanations and clarification about the consultation process, reason why treatment was needed, available alternative treatments and costs throughout their patient experience. This included risks that a treatment may involve. They told us they were treated with dignity and respect by staff and felt safe using the service. They also thought there were enough staff who were suitably qualified to meet their needs. People said "I was very impressed with the care and attention that the dentist and their team provided". People using the service were made aware of the complaints procedure and how to implement it if necessary. They did not comment on the practice infection control systems. They did tell us they thought the practice was kept clean, tidy and observed their right to privacy.