We carried out this announced inspection on 13 April 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 that we were inspecting the practice. They provided information which we took into account.

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

Chingford Dental Surgery in Chingford, London provides NHS and private dental treatment to patients of all ages.

There is level access for people who use wheelchairs and for people with pushchairs. Car parking spaces for patients with disabled badges are available near the practice.

Practice staffing consists of two principal dentists, seven associate dentists, one orthodontist, three hygienists, six dental nurses and two receptionists

At the time of the inspection the practice did not have a registered manager in post. This was being implemented and the practice manager was in the process of applying to the Care Quality Commission.

The practice is open Monday to Thursdays 8.30am to 7pm, Friday and Saturday 8.30am to 1pm.

The practice facilities include six treatment rooms, a decontamination room, reception/waiting area office/X-ray room and staff room.

On the day of inspection we collected 21 CQC comment cards filled in by patients and spoke with four other patients. This information gave us a positive view of the practice. Patients told us that they were happy with the treatment and advice they had received.

During the inspection we spoke with the one of the principal dentists, one associate dentist, 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 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 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.
• The practice had thorough staff recruitment procedures. However improvements could be made

At our last inspection on 21 March 2013 we found people were not cared for by staff who were appropriately supported to deliver care and treatment safely. There were inconsistencies in the undertaking of supervisions and appraisals, this meant not all staff received regular supervision and an appraisal.

During this inspection we found the provider conducted regular supervisions and appraisals. Staff files we examined and staff we spoke with confirmed supervisions and appraisals were undertaken and staff were supported in their roles.

We found people were treated with respect and dignity. Staff told us how they maintained people's dignity and privacy when they received treatment from the practice. For example people were consulted in a private area and surgery doors were closed to maintain people's privacy.

People were given an initial assessment before they received treatment from the service. There was documentary evidence oral assessments were undertaken before treatment was administered.

Staff we spoke with were knowledgeable about the different forms and signs of abuse. They told us they had received safeguarding children and adults training. Staff files we reviewed confirmed this.

We found people we spoke with told us they felt the practice was clean. One person told us the practice was "very clean." We found staff were knowledgeable about the practice's decontamination procedures.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There was documentary evidence patient satisfaction surveys were undertaken. We reviewed five surveys completed by people who used the service and found people were satisfied with the service.