We carried out an announced comprehensive inspection of this service on 25 June 2015 as part of our regulatory functions. 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 undertook this focused inspection on 13 October 2015 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for West Dulwich Dental on our website at www.cqc.org.uk.

We carried out an announced comprehensive inspection on 25 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 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.

West Dulwich Dental is located in the London Borough of Lambeth. The premises consist of one treatment room, a dedicated decontamination room, waiting room with reception area and toilet.

The practice provides private dental services and treats both adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and bridges, and oral hygiene.

The staff structure of the practice is comprised of a principal dentist (who is also the owner), a dental nurse and a receptionist.

The practice is open Monday, Tuesday and Thursday from 9.00am to 5.30pm and on Wednesday from 1.00pm to 8.00pm.

A new provider took over the practice in April 2014 and registered with the Care Quality Commission (CQC) at that time. We carried out an announced, comprehensive inspection on 25 June 2015. The inspection took place over one day and was carried out by a CQC inspector and dentist specialist advisor.

30 people provided feedback about the service. Patients we spoke with, and those who completed comment cards, were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with best practice guidance such as from the National Institute for Health and Care Excellence (NICE).

• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.

• Patients indicated that they felt they were listened to and that they received good care from a helpful and patient practice team.

• The practice had implemented clear procedures for managing comments, concerns or complaints.

• The principal dentist had a clear vision for the practice and staff told us they were well supported by the management team.

• Governance arrangements were in place to guide the management of the practice. This included having appropriate policies and procedures and staff meetings.

• Monitoring arrangements were however, not effective in improving the quality and maintaining the safety of the service

• Medicines required for the management of medical emergencies had recently expired and needed replacing.

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

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

• Review availability of medicines to manage medical emergencies giving due regard to guidelines issued by the British National Formulary.

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

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

• Ensure that all staff are up to date with training requirements including X-ray and basic life support training.

• Disseminate information contained within the Control of Substances Hazardous to Health (COSHH) file to ensure that all staff understand how to minimise risks associated with these substances.

• Carry out a practice-wide risk assessment in relation to Legionella in order to identify any changes or monitoring practices which need to be implemented.

• Ensure audits such as those related to infection control, X-rays and dental care records are undertaken at regular intervals to assess and improve the quality of service.