We carried out an announced comprehensive inspection of this service on 19 June 2015 as part of our regulatory functions where a breach of legal requirements was found. After the comprehensive inspection, the practice wrote to us to say what they would do to meet the legal requirements in relation to the breach.

We carried out a follow- up inspection on 7 June 2016 to check that they had followed their plan and to confirm that they now met the legal requirements. This report only covers our findings in relation to those requirements. We revisited Walworth Road Dental Care as part of this review.

You can read the report from our last comprehensive inspection by selecting the 'all reports' link for Walworth Road Dental Care our website at www.cqc.org.uk.

We carried out an announced comprehensive inspection on 19 June 2015 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 not providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was not providing well-led care in accordance with the relevant regulations.

Walworth Rd Dental Care is a general dental practice near Elephant and Castle, London offering both NHS and private dental treatment. The practice treats adults and children.

The premises consists of a waiting area separate from the reception area and six treatment rooms over three floors. There is also a separate decontamination room and a basement area comprising of an office, stock room and filing storage room.

The staff structure of the practice consists of the practice manager (who is also a registered dental nurse), four dentists, a dental nurse, two trainee dental nurses, a receptionist and a trainee receptionist.

The practice has the services of two part time dental hygienists who carry out preventative advice and treatment on prescription from the dentists.

The practice manager is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered 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. On the day of our inspection the practice manager was not working at the practice.

On the day of our inspection we reviewed six comment cards that had been completed by patients. Common themes were patients felt they received professional, gentle dental care from friendly staff in a clean environment. One patient commented they always had to wait a long time for the telephone to be answered.

Our key findings were:

• There were effective systems to assess and manage risks to patients for infection prevention and control and the management of medical emergencies.

• There were effective arrangements in place to meet the Control of Substances Hazardous to Health 2002 (COSHH) regulations.

• There were effective staff recruitment and selection procedures in place.

• The practice had an efficient system in place to ensure all equipment in use was safe, and in good working order.

• Patients’ dental care records we reviewed provided a full and accurate account of the care and treatment they had received.

• Patients told us through comment cards they were treated with kindness and respect by staff.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• There were insufficient numbers of staff available (particularly on reception) to effectively support patients’ needs.

• Staff did not always receive such appropriate support and appraisal as is necessary to enable them to carry out the duties they are employed to perform.

• There was a lack of an effective system to assess, monitor and improve the quality and safety of the services provided.

• There was a lack of an effective system to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors.

• There was a lack of effective processes for acknowledging, recording, investigating and responding to complaints, concerns and suggestions made by patients.

We identified regulations that were not being met and the provider must:

• Ensure there are sufficient numbers of staff available to effectively support patients’ needs.

• Ensure staff receive such appropriate support and appraisal as is necessary to enable them to carry out the duties they are employed to perform.

• Establish an effective system to assess, monitor and improve the quality and safety of the services provided.

• Establish an effective system to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients, staff and visitors.

• Establish an effective process for acknowledging, recording, investigating and responding to complaints, concerns and suggestions made by patients.

You can see full details of the regulations not being met at the end of this report

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

• Establish a process for monitoring the referral of patients for dental treatment and specialist procedures to other healthcare professionals which ensures timely access to care and treatment.

• Ensure enough (as is reasonably practicable) time is allocated to support patients’ care and treatment needs.

• Establish an effective system to monitor environmental cleaning to ensure adequate floor cleanliness in the treatment rooms and decontamination room.