We carried out this announced inspection on 24 August 2017 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. NHS England provided information which we took into account.

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

Whalebone Lane Dental Clinic is located in Romford in the London Borough of Havering and provides predominantly NHS and some private dental treatment to patients of all ages. The practice carries out dental treatments using conscious sedation techniques by referral for patients who may benefit, such as anxious patients or those undergoing complex treatments.

The practice is located on the ground and first floor of purpose built premises with easy access to public transport links. There is level access and a passenger lift for people who use wheelchairs and those with pushchairs.

The dental team includes six dentists, six dental nurses, two trainee dental nurses and a recovery nurse. The clinical team is supported by the practice manager and five receptionists.

The practice has five treatment rooms.

The practice is owned by a company 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 Whalebone Lane Dental Clinic was the operations manager.

We received feedback from eight patients via CQC comment cards and speaking with patients. This information gave us a positive view of the practice.

During the inspection we spoke with three dentists, three dental nurses, two receptionists, the practice manager and the registered manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between 8.30am and 1pm and 2pm to 5.30pm on Mondays to Fridays. The practice is open at lunchtime for new patient registrations and appointment bookings.

Our key findings were:

• The practice was 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 appointment system met patients’ needs.
• The practice had effective leadership. 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.

People who use the service understood the care and treatment choices available to them. People told us that treatments were clearly explained to them, and they were able to ask questions about anything they did not understand. One person said "I knew what I was getting done today. She (the dentist) gave me two choices."

People’s needs were assessed and care and treatment was planned and delivered in line with their individual treatment plan. People told us they were happy with the care and treatment they received. One person said "they are really gentle, it took the fear out of it."

We found that the service was visibly clean and that suitable arrangements were in place for the control of infection. Staff received training and appropriate continuing professional development. People we spoke with said they had not had to make a complaint about the service, but knew who they could complain to if they so wished. One said "I would tell the dentist if I was not happy about something." We found the service had a complaints procedure in place and complaints received had been investigated in line with the procedure.