We carried out this announced inspection on 14 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 providing well-led care in accordance with the relevant regulations.

Background

Cedars Dental Practice is in Leyton in the London Borough of Waltham Forest. The practice provides NHS and private treatment to patients of all ages.

There is step frees access to the practice and two surgeries are located on the ground floor. The practice is situated close to public transport bus and train services.

The dental team includes the principal dentist, five dentists who work at the practice on a part time basis, one dental foundation year one (DFY1) dentist, four dental nurses, two trainee dental nurses and a dental hygienist. The clinical team are supported by a practice manager and a receptionist. The practice has four treatment rooms, three of which were in use at the time of our inspection.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection we received feedback from 86 patients.

During the inspection we spoke with two dentists, the DFY1 dentist, two dental nurses, the receptionist and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

Mondays to Fridays 9am to 6pm.

Saturdays 10am to 2pm

The practice closes between 1pm and 2pm each day for lunch

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 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 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.

One person we spoke to told us they had not attended a dentist for more than ten years and when they came to this practice the dentist explained all the treatment options and they chose what they could afford. They said they were asked to sign a form before any treatment was given.

The practice manager told us they carried out comprehensive examinations of people when they first attend the surgery which included soft tissue examinations and discussions about personal habits. They said they used videos where necessary to help people to understand the different treatment options and the process involved.

The practice had a cross infection control policy and we saw that all staff had signed it to say they had read and understood it. The manager carried out a monthly infection control audit using a department of health (DOH) audit tool.

People were cared for in a clean, hygienic environment. One person we spoke to said they found the practice to be very clean every time they attended.

Staff we spoke to told us they felt well supported in their work. They said they had an induction when they first started which included shadowing a member of staff for a week, attending training and familiarising themselves with policies and procedures.

The practice manager told us that all patients were asked to complete a feedback form. One person we spoke to said they had been asked but had never completed one because if they were unhappy they would just say so at the time.