We carried out this announced inspection on 7 December 17 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 area team that we were inspecting the practice. They did not provide any information.

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

Dental Practice Norbury is in Croydon and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and pushchairs. Car parking spaces are available for patients at the front of the practice as well as surrounding roads.

The dental team includes three dentists (including an orthodontist), three dental nurses, one dental hygienist and two receptionists. The practice is set out over two levels with one surgery on the ground floor and one on the first floor. Other rooms include a staff room, decontamination room and patient waiting room with reception area.

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 collected 25 CQC comment cards filled in by patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists (including the orthodontist), two dental nurses and one of the receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday 9.00-6.30pm, Tuesday and Thursday 9.00-5.00pm and Wednesday and Friday 9.00-3.00pm.

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.

We carried out this inspection to determine if the provider had taken action to rectify the areas of non-compliance that were found at our last inspection carried out in January 2014.

At the inspection in April 2014 we found that a new recruitment policy and procedures had been introduced. These included pre-assessment checklists, interview questions and an interview assessment form.

We found that people’s needs were assessed and treatment was planned. People felt involved in their treatment planning. One person told us, "We discuss the different options and once I've decided, he explains what he is doing as he is doing it."

People were satisfied with their care and treatment. One person told us, "The staff are really nice, I've always had excellent customer service and I've been coming here for eleven years now." People were also happy with the way their treatment was delivered. One person told us, "It's excellent." Another person said, "It's good."

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff were trained in safeguarding vulnerable adults and had a good knowledge about protecting people from abuse. People were protected from the risk of infection because appropriate guidance had been followed.

However, we were concerned that there were not effective recruitment and selection procedures in place and appropriate checks were not always carried out before staff began to work with people.

Staff told us they felt supported by the provider. We found that staff received appropriate professional development, training and supervision.

We spoke with three people who use the service during the visit. They were very positively about the attitude, care and treatment provided by the practice team. They told us their privacy was always respected and the practice was always comfortable, clean and tidy. They said they did not have to wait long for an appointment.