We carried out this announced inspection on 29 January 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.

We told the NHS England we were inspecting the practice. They provided information which we took into account.

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 Fulham Dentist is located in Fulham and provides NHS and private treatment to patients of all ages.

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

The dental team includes two dentists, two dental nurses, two dental hygienists, a dental therapist a receptionist and a practice manager. The practice has two treatment rooms.

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 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, a 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 9.00am to 6.00pm Monday to Friday, with extended opening till 7.00pm on Wednesday and alternative 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 staff recruitment procedures, although improvements could be made in relation to recording references
• 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.

We spoke with people using the service who told us that their treatment had been "fully explained" and that they "always discuss options" with the dentists. 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 "excellent".

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

There were safeguarding policies in place, staff had completed safeguarding vulnerable adults and child protection training.

On the day of the inspection the practice was clean and tidy. There were policies and procedures in place on how to maintain a clean and hygienic environment and staff carried out regular checks and completed records 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 treatments they provided.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.