We carried out this announced inspection on 29 August 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 area team and Healthwatch that we were inspecting the practice. NHS England 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

Essence Dental Clinic is located in Harold Hill in the London Borough of Havering and provides predominantly NHS and some private dental treatment to patients of all ages.

The practice is located on the ground and first floor of purpose adapted premises with onsite parking and easy access to public transport links. There is level access via a ramp for people who use wheelchairs and those with pushchairs.

Essence Dental Clinic is a training practice and part of the Health Education-England, North East London scheme for foundation training.

The dental team includes the principal dentist, seven associate dentists and one vocational trainee dentist, four dental nurses, one dental hygienist and two receptionists.

The practice has five treatment rooms, two of which are located on the ground floor.

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.

We received feedback from 18 patients via CQC comment cards and speaking with patients. This information gave us a positive view of the practice.

During the inspection we spoke with the principal dentist and the vocational trainee dentist, two dental nurses and both receptionists. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between 9am and 5.30pm on Mondays, Tuesdays and Fridays and between 9am and 7pm on Wednesdays and Thursdays. Private appointments are available on Saturdays by pre-booked appointments. The practice is open at lunchtime for new patient registrations and appointment bookings.

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.

People we spoke with told us they were respected and treated well. They felt they were able to express their views and were involved in making decisions about their treatment. A person we spoke with said “the staff here are polite, respectful and very good. They are always friendly and it is an excellent service.” Another person said “I try to avoid the dentist but they put me at ease here.”

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. We found measures had been taken to reduce the risks of people receiving unsafe or inappropriate care.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse. There was a safeguarding policy in place for the protection of vulnerable children and adults

The provider had taken steps to ensure there were systems in place to assess the risk and control the spread of health care associated infection. We saw people had written positive comments on the surveys they had recently completed.