We carried out this announced inspection on 16 May 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 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 Care Dental Practice is in Hammersmith and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs.

The dental team includes five dentists (one of whom was one of the two practice managers), one head dental nurses, three trainee nurses, three receptionists and a practice manager.

The practice has four treatment rooms, a decontamination room and a reception/waiting area.

The practice is owned by a partnership 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 care dental practice was the principal dentist.

On the day of inspection we collected seven 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, two dental nurses, two receptionists and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open 9.30am to 18.00pm. Monday to Thursday, 8.00am to 20.00pm Wednesdays and Fridays and 10.00am to 15.00pm Saturdays. .

Our key findings were:

• The practice was 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 safe recruitment procedures in place; however improvements could be made.
• 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.

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

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.
• Review the protocols and procedures for use of X-ray equipment taking into account Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.

We spoke with people using the service who told us that their treatment had been "fully explained" and that the dentists "always discussed options" with them. In recent patient feedback, when asked about staff being helpful and knowledgeable, and whether they received adequate information about their treatment the majority of people rated the practice as "good".

People using the service described it as "good" and said that medical histories were taken prior to treatment being provided. In recent patient feedback people said they were "looked after appropriately". Staff had been trained in what to do in a medical emergency. There were emergency drugs and equipment available in the practice.

On the day of the inspection the practice was tidy; however there were areas that required staff to pay more attention to including under chairs and on top of cupboards. There were policies and procedures in place on how to maintain a clean and hygienic environment and staff made regular checks to ensure that these were being followed.

All staff underwent appropriate training on an annual basis in relevant mandatory topics such as medical emergencies and decontamination, as well as training specific to the treatments they provided.

The provider had a complaints policy and procedure that all staff were aware of. The complaint procedure was on the notice board in the reception and there was also a comments box with forms available for people to use.