We carried out this announced inspection on 5 June 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

Valentine Dental is in Ilford in the London Borough of Redbridge. The practice provides NHS and private treatment to patients of all ages.

The practice is located on ground level and there is step frees access for people who use wheelchairs and those with pushchairs. The practice is situated close to public transport bus and underground services.

The dental team includes the principal dentist, one dental nurse and one receptionist. The practice has two treatment rooms, one of which was in use at the time of our inspection.

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 received feedback from 29 patients.

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

The practice is open:

Tuesdays to Fridays between 9am and 5pm.

The practice closes between 1pm and 2pm each for lunch

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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 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.

• The practice had infection control procedures which reflected published guidance. Improvements were needed to ensure that infection prevention and control audits were carried out in line with current guidance.

• Improvements were needed to the practice systems to help them better manage risk.
• Improvements were needed to practice leadership to help promote a culture of continuous improvement.

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

• Review the use of risk assessments to monitor and mitigate the various risks arising from undertaking of the regulated activities.

• Review the practice’s audit protocols to ensure infection control audits are undertaken at regular intervals and where applicable learning points are documented and shared with all relevant staff.
• Review its responsibilities as regards the Control of Substances Hazardous to Health (COSHH) Regulations 2002 and ensure all documentation is up to date and staff understand how to minimise risks associated with the use and handling of these substances.
• Review the systems for checking and monitoring equipment taking into account current national guidance and ensure that all equipment is well maintained.

We found a clean well maintained, practice situated in converted house on a residential high street. Three patients who we spoke with told us they were happy with the service provided. They felt they were given enough information about their treatment options as well as the fee scales and had no hesitation in asking any question in relation to their treatment or cost.

They told us they found the staff to be friendly and accommodating, and patients were happy to report that they were treated with respect and dignity as well as maintaining privacy. Consultations took place within private surgeries where privacy and confidentiality were ensured. We observed the receptionist speaking in an extremely pleasant manner to patients at the reception area.

Patients were able to make comments about their experience via feedback cards on display in the waiting room. They were also encouraged to make suggestions for the better running of the practice. They told us “the dentist was extremely helpful in explaining the treatment as well as the cost”.

Treatment records of all types were maintained electronically, as well as on paper record cards together with all correspondence with respect to each patient. We observed that patients completed a medical history at their first visit and prior to any consultation or treatment with the dentist. We also observed medical histories being updated for several patients. Consent forms were signed before any treatment was commenced.