We carried out this announced inspection on 9 April 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 this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

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

Are services caring?

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

Are services responsive?

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

Are services well-led?

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

Background

Urgent Dental Care is in Barnet and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice.

The dental team includes the principal dentist, two dentists, one dental hygienist, one dental nurse, four trainee dental nurses, one receptionist and a practice manager. The practice has two treatment rooms.

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 Urgent Dental Care was the principal dentist.

On the day of inspection we collected 26 CQC comment cards filled in by patients, all were very positive.

During the inspection we spoke with the principal dentist, two dentists one dental nurse, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Sunday to Thursday 9am to 10pm.
• Friday 9am to 3pm
• Out of Hours information displayed on website.

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 suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children. However, not all staff had completed safeguarding training.
• 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.
• Staff felt involved and supported and worked well as a team.
• The practice asked patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

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

• Review the practice's protocols and procedures for the use of X-ray equipment taking into account the Guidance Notes for Dental Practitioners on the Safe Use of X-ray Equipment.
• Review the practice’s protocols to ensure audits of various aspects of the service, such as radiography is undertaken at regular intervals to improve the quality of service. The practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.
• Review the practice's protocols for medicines management and ensure all medicines are stored and dispensed of safely and securely.
• Review staff training to ensure that all the staff have received training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities.

On the day of our visit we spoke to one patient but could not get much feedback as they could not communicate effectively in English. We reviewed feedback from one questionnaire received and feedback from the website, and found patients were satisfied with the care they received.

We reviewed five care records and found that care was assessed and planned according to individual needs and treatment cost and choices were explained and documented. Staff were able to tell us where to locate emergency medications and the procedure to follow in an emergency.

The premises were clean. Staff wore clean uniforms and told us they had access to protective clothing. Staff demonstrated knowledge of decontamination guidelines and showed us how they cleaned the consulting room before and after each patient.

There was a suggestion box at the main reception. Patient satisfaction questionnaires were available for patients at reception. Infection control audits had been completed as well as radiation risk assessments. Staff told us that they felt supported by the manager and that they were given the opportunity to attend regular courses. There were inadequate systems in place to monitor the quality of care received as there was no structure or predetermined frequency of audits or staff meetings.