We carried out this announced inspection on 22 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 that we were inspecting the practice. They had no information of concern.

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

Adams Dental in the London borough of Enfield and provides NHS treatment to children and private dental treatment to patients of all ages.

Practice staffing consists of two principal dentists, three dentists, periodontist, hypnotherapist, two hygienists, two dental nurses, one trainee dental nurse and a receptionist.

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 Adam Dental was one of the principal dentist

The practice is open Monday, Tuesday and Friday 9am to 6pm, Tuesday and Wednesday 9am to 8pm and every other Saturday 10am to 1pm

The practice facilities include three treatment rooms, a decontamination room, waiting areas, reception area, and a staff room.

On the day of inspection we collected feedback from 65 patients. This information gave us a positive view of the practice.

During the inspection we spoke with both the principal dentists, two dental nurses and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

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.

Patients told us they were happy with the service they received. Comments about the service from patients consisted of "very good" and staff were described as being, "Very polite." Records showed that treatment options had been discussed with patients. A patient had told us, “The Dentist explains the treatment options to you.” Patients told us that the dentist put them at their ease by explaining clearly what treatment they were going to receive. There were clear records of the treatment provided to patients.

Patients appeared calm and relaxed when talking to staff. Patients told us that the clinic was always clean. Staff understood how to respond to the risk of infection to maintain the safety of patients.