We carried out an announced comprehensive inspection on 10 March 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

The 99 Harley Street practice is located in the London Borough of Westminster. The premises are situated in a converted residential building. There are two treatment rooms, a reception room and a kitchen on the second floor of the building. There is a dedicated decontamination area in one of the treatment rooms. There is lift access to the second floor and the use of shared toilet facilities throughout the building.

The practice provides private dental care services to adults and children. The practice only offers specialist endodontic services on referral or by self-referral.

The staff structure of the practice consists of a principal endodontist, an associate endodontist, three dental nurses, a practice manager and an operations manager. There is also a visiting anaesthetist who provides conscious sedation, when required.

The practice opening hours are on Mondays to Fridays from 9.00am to 5.30pm.

The operations manager is 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.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Eleven people provided feedback about the service. Patients 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 current guidance such as from the British, European and American Endodontic Societies.

• There were effective systems in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• There were effective arrangements in place for managing medical emergencies.
• 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 caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

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

• Review the current Legionella risk assessment and implement the required actions including the monitoring and recording of water temperatures.

People who use the service told us that their consultation and treatment is undertaken in the privacy of the consulting rooms. They told us that staff were polite and respectful and that the dentist, Dr Michael Sultan was skilled at putting them at ease.

People told us they get sufficient information about the cost of treatment prior their appointment.