We undertook a follow up desk-based focused inspection of 33 Beaumont Street on 11 December 2018. This inspection was carried out to review in detail the actions taken by the registered provider to improve the quality of care and to confirm that the practice was now meeting legal requirements.

The inspection was led by a CQC inspector.

We undertook a comprehensive inspection of 33 Beaumont Street on 25 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We found the registered provider was not providing well led care and was in breach of regulation 19 Fit and Proper Persons employed of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read our report of that inspection by selecting the 'all reports' link for 33 Beaumont Street dental practice on our website www.cqc.org.uk.

As part of this inspection we asked:

• Is it well-led?

When one or more of the five questions are not met we require the service to make improvements and send us an action plan. We then inspect again after a reasonable interval, focusing on the area where improvement was required.

Our findings were:

Are services well-led?

We found this practice was providing well-led care in accordance with the relevant regulations.

The provider had made improvements in relation to the regulatory breach we found at our inspection on 25 June 2018.

Background

33 Beaumont Street is in Oxford and provides private treatment to patients of all ages.

There is level access, via a ramp is available for people who use wheelchairs and those with pushchairs via the side entrance of the practice.

The dental team includes six dentists, one anaesthetist an oral surgeon, five dental nurses, one dental hygienist, one dental hygienist therapist, and administrator and two receptionists. The practice has four 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 33 Beaumont Street was the principal dentist.

The practice is open Monday to Friday 9am to 5.30pm.

Our key findings were:

• The practice had recruitment procedures which were operated effectively to ensure only fit and proper persons were employed.

We carried out this announced inspection on 25 June 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 not providing well-led care in accordance with the relevant regulations.

Background

33 Beaumont Street is in Oxford and provides private treatment to patients of all ages.

There is level access, via a ramp is available for people who use wheelchairs and those with pushchairs via the side entrance of the practice.

The dental team includes six dentists, one anaesthetist an oral surgeon, five dental nurses, one dental hygienist, one dental hygienist therapist, and administrator and two receptionists. The practice has four 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 33 Beaumont Street was the principal dentist.

On the day of inspection, we collected 14 CQC comment cards filled in by patients and obtained the views of 11 other patients.

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

The practice is open Monday to Friday 9am to 5.30pm.

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 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.

We identified regulations the provider was not meeting. They must:

• Ensure recruitment procedures are established and operated effectively to ensure only fit and proper persons are employed.

There were areas where the provider could make improvements. They should:

• Review the practice's responsibilities to consider the needs of patients with vision or hearing impairments and to comply with the requirements of the Equality Act 2010.
• 'Review staff training to ensure that dental nursing staff who assist in conscious sedation have the appropriate training and skills to carry out the role, considering guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015'.