We carried out an announced comprehensive inspection on 18 July 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

TLC Dental located in Newham provides NHS and private dental treatment to patients of all ages.

Practice staffing consists of the principal dentist, four associate dentists, one oral surgeon, one dental therapist, two receptionists and the practice manager.

The principal dentist is registered with the Care Quality Commission (CQC) as an individualregistered persons. Registered persons 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 practice is open Monday to Friday 9.00am to 5.00pm

The practice facilities include four treatment rooms, reception area, two waiting areas, two decontamination rooms, one office and a staff room/kitchen.

We reviewed 21 CQC comment cards, the practice patient satisfaction survey and the NHS Friends and Family test comment cards. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.

• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice.
• Patients had good access to appointments, including emergency appointments, which were available on the same day
• The practice sought feedback from staff and patients about the services they provided and acted on this to improve its services.
• The practice had not ensured that appropriate medicines, in line with British National Formulary and Resuscitation Council (UK) guidance, were available to respond to a medical emergency.

There were areas where the provider could make improvements and should:

• Review availability of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the security of prescription pads in the practice and ensure there are systems in place to monitor and track their use.

People mentioned that they were given clear information about the treatment choices available to them so that they could come to a decision about which treatment would be best for them.

People received their consultations in private rooms. We saw that staff ensured that doors were closed to ensure that people's privacy was respected.

The practice had a large reception area which contained a variety of information leaflets, which were available to people who visited the practice. These included information about the practice and dental healthcare.

We looked at some of the surgery records. We saw people had treatment plans which took into account their relevant medical history, explained their treatment needs and possible options. Advice was given when needed and costs were recorded and provided to patients. One person said “The treatment options were explained thoroughly and I am very pleased with all the work I had done.”

We saw that the practice had infection control systems in place. The provider undertook regular infection control audits to monitor and review the quality and safety of the service provided.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.