We carried out this announced inspection on 1 April 2019 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

Watford Dental Practice is a well-established practice that provides both private and NHS treatment to about 7,000 patients. The dental team includes eight dentists, two hygienists, seven nurses and various administrative staff. There are four treatment rooms.

The practice opens on Monday to Thursday from 9am to 5.30pm; and on Friday from 9am to 5pm.

The practice 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 practice is run. The registered manager at the practice is one of the partners.

On the day of inspection, we spoke with two dentists, the practice manager, and nursing and reception staff. We looked at practice policies and procedures and other records about how the service is managed. We collected 45 comment cards that had been completed by patients.

Our key findings were:

• The practice had effective systems to help ensure patient safety. These included safeguarding children and adults from abuse, maintaining the required standards of infection prevention and control, and radiation management.

• Risk assessment was robust and action was taken to protect staff and patients.

• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance. Dental care records were of a good standard.

• Patients received their care and treatment from well supported staff, who greatly enjoyed their work.

• The practice had effective leadership and a culture of continuous audit and improvement.

• The practice asked staff and patients for feedback about the services they provided. Staff felt involved and worked well as a team.

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

• Review the security of prescription pads in the practice and ensure there are systems in place to track and monitor their use.

• Review the practice's recruitment procedures to ensure that appropriate background checks are completed prior to new staff commencing employment at the practice.

Everyone we spoke with said they were mostly happy with the care they received from the provider. One person said “They are pleasant, helpful and respectful.” Another person said “I would change my dentist if I was not happy here.”

We found that the provider had processes in place to ensure people had comprehensive individualised treatment plans. We identified that people were given the opportunity to participate in decisions relating to their care. We noted that the provider took reasonable steps to ensure the risk of treatment related infections was minimised. Staff we spoke with felt they were well supported and given ample opportunities to attended training and updates. The provider had systems in place to protect people from the risk of abuse.