We carried out this announced inspection on 12 July 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

West London Dental Centres is in Chiswick in the London Borough of Hounslow. The practice provides NHS and private treatment to patients of all ages.

The practice has four dental surgeries, two of which are located on the ground floor. We were told physical refurbishments to the building to make it accessible to patients in wheelchairs was not possible. The practice has made arrangements for patients with limited mobility who require support or wheelchair access to be treated at a neighbouring practice which has accessible facilities. The practice is situated close to public transport bus and train services.

The dental team includes two dentist partners, three associate dentists and three dental nurses. The clinical team are supported by two receptionists.

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 West London Dental Centres was one of the dentist partners.

On the day of inspection we received feedback from 13 patients.

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

The practice is open:

Mondays to Thursdays between 9am and 6pm.

Fridays between 9am to 5pm

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

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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.
• The practice had effective leadership and culture of continuous improvement.
• 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.

During the inspection we talked with two people using the service and four members of staff to get their views about the service that was provided in the dental practice.

People who talked with us said they were very happy about the care they received. One person said “I am very happy with my dentist and would recommend them anytime”.

People’s dental and oral condition was appropriately assessed before the dentists recommended treatment to people. Most treatment records confirmed this. The practice had arrangements for the dentists to explain the various treatment options and the costs, so people could make an informed decision about the treatment they wanted. One person said “the dentist explains everything for me to understand my treatment”.

The dentists ensured that a full medical history and information about their medicines was available for each person to ensure they had all the relevant information to consider before treating people. There was a procedure to deal with medical emergencies and staff had received training in this area so they could provide appropriate first aid to people, if this was required.

The practice carried out audits to assess and monitor the quality of the service that it provides. A satisfaction survey had been carried out to formally ask people for their views of the service. Where areas for improvement had been identified, actions plans were in place to address these.