We carried out this announced inspection on 27 June 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

The Balcombe Practice Limited is in the London Borough of Enfield and provides NHS and private treatment to adults and children.

The dental team includes a principal dentist, three dentists, a periodontist an oral surgeon, an endodontist, three dental nurses, three hygienists and a receptionist

The practice is owned by an organisation 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 The Balcombe Practice limited was the principal dentist.

On the day of inspection, we collected 42 CQC comment cards filled in by patients.

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

The practice is open:

• Monday to Friday 8am to 6pm
• Saturdays 8am 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 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.

We found this to be a friendly and patient centred practice. The team had a good relationship with each other and the people attending for treatment. We saw a high level of training and organisational skill. They were ably led by a very focussed provider.

We followed a patient pathway and we observed high levels of care and interaction with the person. Two people told us the staff were "lovely." They told us their privacy and dignity was respected. One said "I would recommend anyone".

People who use the service were given appropriate information and support regarding their care or treatment. Patient feedback was gathered and used to inform improvements in the service.