We carried out this announced inspection on 29 August 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.

We told the NHS England area team and Healthwatch that we were inspecting the service. They did not provide any information .

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 service was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this service was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this service was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this service was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this service was providing well-led care in accordance with the relevant regulations.

Background

White House Dental Service provides NHS domiciliary treatment to patients within London Borough of Ealing. This service is provided in either a care home setting or in the patients’ own home.

The dental team includes one dentist, one dental nurse and one administrator.

The service 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 service is run. The registered manager at White House Dental Service was the clinical director.

On the day of inspection we collected 12 CQC comment cards filled in by patients. This information gave us a positive view of the service.

During the inspection, we looked at service policies, procedures, and other records about how the service is managed.

The service is open:

• Wednesday: 9:00am to 6:00pm

Our key findings were:

• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The service had systems to help them manage risk.
• The service had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• The service had thorough staff recruitment procedures.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The appointment system met patients’ needs.
• The service had effective leadership. Staff felt involved, supported, and worked well as a team.
• The service asked staff and patients for feedback about the services they provided.
• The service dealt with complaints positively and efficiently.

We identified areas of notable practice:

The provider proactively engaged with the local community in a variety of ways to improve oral health for various population groups, for example:

• Partnering with various local and national initiatives to raise oral health awareness, for example, the East African Senior Citizens Association, the Mael Gael and Sunrise Radio.

Patients told us they were happy with the quality of the service they received. They told us they were treated with dignity and respect by a staff team who were professional and caring. All patients we spoke with said the practice had been recommended to them by family or friends. One patient said “I enjoy coming here, my dentist is very good” and “it’s like a family here”. Patients told us it was easy to get an appointment which suited them.

Patients said clear explanations of the various treatment options and costs were explained to them by the dentist and that they were able to ask questions to clarify anything that was not clear.

Patients said that the practice responded very well if they needed treatment urgently. One patient told us “we telephoned first thing in the morning and were given an appointment to come in within the hour”.

People told us they felt safe whist having their treatment, comments from patients included “they make you very comfortable and you feel safe” and “I have peace of mind when I come here”. Patients told us that the practice environment was clean and hygienic. They also said that they were given ample opportunities to feedback on the quality of the service.