This visit was a follow up to our inspection of both providers on the 6 August 2014. At that inspection, we found that the practice was not compliant with the requirements of Regulation 20 (1) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The provider had not ensured that people were protected from risk of unsafe or inappropriate treatment arising from lack of proper clinical records about people who use the service.

Following that inspection the provider sent us a plan of the actions it intended to take to comply with the regulations. We made this visit to check that the actions had been implemented. We found that the provider had taken appropriate and sufficient action and was now compliant with the regulations.

There are two registered providers who provide dental services from the same building and they are both registered with the same location name Complete Dental Care. Although the providers share staffing arrangements, the reception desk and the waiting room they have been inspected separately. This report relates to Dr Sunita Daswani.

During the last inspection, on 19 March 2014, we found the provider had not completed all the necessary actions to be compliant with the standards and regulations for record keeping. We judged that the provider had not ensured people were protected from the risk of unsafe or inappropriate treatment arising from the lack of proper records. The provider was issued with a warning notice to make improvements.

At the recent inspection on 6 August 2014 we saw improvements had been made with the practice management records. However, we found the patient’s clinical notes were still missing significant information about the treatment they had received. The provider provided some evidence to us after the inspection because they were unavailable on the day of the visit. The information demonstrated that some improvements had taken place or were in the process of being implemented.

This inspection was a follow up to our visits on 13 February 2013 and 2 September 2013. We had noted some issues which we judged had a moderate impact on people using the service. These related to the standard of record keeping. The provider had not ensured people were protected from risk of unsafe or inappropriate treatment arising from a lack of proper records. They did not maintain accurate records about people who use the service, nor records relating to the management of the regulated activity. Patient records were not kept securely. We set compliance actions requiring the provider to take steps to comply with Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

We made a further visit on 19 March 2014 to check on the action the provider had taken to meet the requirements of the regulation. We found that the provider had not taken appropriate action to fully comply with the regulations. We noted an improvement in the way advice given to patients and how routine checks were recorded. However, patients’ records were not kept securely and the provider did not maintain accurate records relating to the management of the service and staff employed by the provider.

This report is a follow up to our report published in May 2013. We had inspected this provider on 13 February 2013, when we noted some issues which had a minor and moderate impact on people using the service. These related to cleanliness and infection control, supporting workers, and records. The provider did not ensure that people were protected from the risk of infection, staff were not appropriately supported in their job, records were not fit for purpose, neither were they kept safe.

We set compliance actions requiring the provider to take steps to comply with Regulations 12, 20, and 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

We made a further visit on 30 August 2013 to check on the action the provider had taken to meet the requirements of the regulations. We found that the provider had ensured people were treated in clean environment and were protected from the risk of infection. We saw that staff had been supported at their work. However, we assessed that the provider had not made sufficient improvements to ensure records were suitably maintained and the provider had not ensured records were stored securely.

Patients were complimentary about the practice they said that the staff were "very good". They felt that they were treated with respect and dignity. They told us that they were "fully informed" about the choices, costs, alternatives and possible outcomes of their treatment.

The practice was friendly, welcoming and informative. Patients were consented appropriately. We found the provider had not implemented systems to assess the risk and prevent and monitor the prevention and control of infection. Staff were not supported to deliver care and treatment appropriate to their role. Records were not well maintained, accurate or stored securely.