We carried out an announced comprehensive inspection on 31 January 2017 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

Well St Dental Care is located in the London Borough of Hackney and provides NHS and private dental services.

The opening hours for the practice were Monday to Friday 9.00am am to 6.30pm.

The premises consist of three treatment rooms, a decontamination room, and a reception area.

The practice comprises of three dentists, four nurses an assistant manager and a practice manager.

The provider’s head of compliance was 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.

During the inspection we asked patients to complete CQC comment cards. We received feedback from eight patients. The patients who provided feedback were positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be caring and helpful and they were treated with care, dignity and respect.

Our key findings were:

• There were effective processes in place to reduce and minimise the risk and spread of infection.
• 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).
• Patients were involved in their care and treatment planning.
• There was appropriate equipment for staff to undertake their duties and equipment was well maintained.
• Staff were trained in and there was appropriate equipment for them to respond to medical emergencies.
• Patients told us that staff were caring and treated them with dignity and respect.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• There were processes in place for patients to give their comments and feedback about the service including making complaints and compliments.

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

• Review the protocol for completing accurate, complete and detailed records relating to employment of staff.

• Review its audit protocols to document learning points that are shared with all relevant staff and ensure that the resulting improvements can be demonstrated as part of the audit process.

We found that the provider had made improvements to the service.

The dental chairs had been serviced and equipment used to transfer instruments were also in good condition. The staff team had reviewed the decontamination process and reorganised the decontamination area, removing all unnecessary items and poster displays. The dental nurses were using a magnifier to check that they had washed instruments thoroughly in line with national guidance.

Since the last inspection, we noted that the provider no longer stocked or dispensed medicines due to the very low demand for this service. We saw evidence that the service managed the emergency medicines and local anaesthetics appropriately.

Our inspection of 2 April 2012 found that some patients' consultation records did not appear to have been signed by the person receiving the treatment. We reviewed the records of all the people who had visited the service earlier in the day. These had been signed. The provider was also routinely auditing patient records to check their accuracy and completeness.

We spoke with two people using the service and their family members. People said it was easy to obtain an appointment and they had not had to wait long to be seen. People were happy with the service they received. They said the staff were friendly and polite and one person noted that the staff were good at putting children at ease. People felt their privacy was respected. People said the premises were clean enough in their experience.

Although the people we spoke with were happy with the service, we were unable to get a broader picture of people's views because the service had not successfully obtained people's feedback. We also had some concerns about infection control, medicines management and record keeping at the service.