We carried out this announced inspection on 14 May 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 Grove Dental Care is in the London Borough of Enfield and provides NHS and private treatment to adults and children.

The dental team includes a principal dentist, four dentists, one hygienist, four dental nurses, one trainee dental nurse, a receptionist and a practice manager

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 grove Dental Care was the principal dentist.

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On the day of inspection we collected 16 CQC comment cards filled in by patients.

During the inspection we spoke with the principal dentist, one dentist, two dental nurses 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 9.00am to 6.00pm

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 did not speak with patients as the focus of the inspection was to check that specific improvements had been made by the provider.

Staff were aware of patient safety and child protection policies and procedures and had attended training. Staff knew how to recognise abuse and to report any allegations of abuse to the manager, the local authority and police as necessary. This meant that patients and staff were protected from the risks of abuse.

The premises were clean. Records showed that the infection control policies and procedures had been updated, tailored to the needs of the practice and brought to the attention of staff. We saw records of cleaning schedules, infection control checklists and audits signed by staff. This meant that patients and staff were protected against the risks of acquiring an infection.

Patients told us that treatment was explained to them by staff in private, were able to express their views, were involved in making decisions about their care and treatment and were given choices of treatment. One patient told us that “it was nice to be given options and to be asked what treatment I wanted.”

We spoke with staff and saw records that showed care and treatment was planned and delivered in line with their individual treatment plan. Patients were recalled at intervals based on their individual needs. One patient said "the dentist was very reassuring and comforting." All of the patients we spoke with said they would recommend the dentist.

Staff were not aware of some patient safety and child protection policies and procedures and some had not attended training. Some staff knew to report any allegations of abuse to the manager, the local authority and police as necessary.

The premises were clean. We saw that regular audits had been carried out by the provider to monitor infection control guidelines as detailed in Department of Health Technical Memorandum 01-05 (HTM 01-05). However there was no hot water to the ground floor patient WC and first floor staff WC wash hand basins

We saw that most patient's personal records including medical records were stored securely and were kept up to date. Most records were stored appropriately in accordance with the Data Protection Act 1998.