We carried out this announced inspection on 6 June 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.

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

Aromaden Teddington is in London Borough of Richmond Upon Thames and provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs.

The dental team includes two dentists, one dental nurse, one trainee dental nurse, one dental hygienist and two receptionists. The practice has three 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 Aromaden Teddington was the principal dentist.

On the day of inspection we collected 27 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with one dentist, one dental nurse and one receptionist. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday - Tuesday: 9:00am to 5:00pm

• Wednesday – Thursday: 8:00am to 6:00pm

• Friday - Sat: 9:00am to 1:00pm

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.

There were areas where the provider could make improvements, they should:

• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.

Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies, such as Public Health England (PHE).

We spoke with six people who used the practice. People told us that they were treated with dignity and respect and felt fully informed and involved in their care and treatment. People were given full explanations about the procedures for their dental care and were able to ask questions before they consented to treatment. One person said "I was given my copy of the treatment plan so I knew what to expect" and "The dentist explained everything verbally to me so I was able to make a choice". All of the people we spoke with told us that they were very satisfied with their care and treatment.

Staff washed their hands, applied antibacterial hand gel and disposable gloves. This was confirmed by people who received their dental treatments at the surgery. One person commented "The staff wear gloves and face protection masks" and someone else said "They wear special eye protection and offer me this as well".

We checked the verifiable hours (evidence of continuous professional development to remain registered as a dentist) of the practising dentist and found they were appropriately maintained.

People were made aware of the complaints system. The practice provided guidance on whom to contact and which organisations people could take their concerns to, should a complaint be unresolved. People expressed satisfaction with the service. Electronic records were managed professionally. The practice used a dental software package to record, store and maintain people's dental notes.