We carried out an announced comprehensive inspection on 20 July 2015 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

Altmore Dental Practice is located in the London Borough of Tower Hamlets. The practice is based on the ground floor and consists of two treatment rooms, a dedicated decontamination room and a reception area.

The practice provides private dental services and treats both adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers, crowns and bridges and oral hygiene.

The staff structure of the practice is comprised of three dentists, two dental nurses, a hygienist, a practice manager and reception staff. The practice was open Monday to Wednesday from 9.00 to 20.00 and then from 9.00am to 18.00 on a Thursday and from 9.00 to 16.30 on a Friday.

One of the dentists is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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 nurse specialist advisor.

We received eight CQC comment cards completed by patients. Those who completed comment cards, were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance, such as from the National Institute for Health and Care Excellence (NICE).
• Equipment, such as the air compressor, autoclave (steriliser), ultrasonic cleaner, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The dentists had a clear vision for the practice and staff told us they were well supported by the management team.
• Risks to patients and staff had been always been suitably assessed and mitigated.
• National guidance on infection control was followed, though improvements could be made to ensure consistency in the cleaning of used dental instruments.
• Review the practice’s protocols for the use of a rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the practice’s infection control procedures and protocols giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum 01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance’.
• Review the support processes to ensure staff receive regular performance reviews and formal appraisals.
• To maintain written records to evidence that monthly checks were made to help ensure the emergency medicines were safe to use.