We carried out this announced inspection on 12 September 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 Healthwatch 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

Fleet Street Dental Centre is in the City of London and provides private treatment to patients of all ages.

The practice is located on the third floor of a medical centre. There is level access to the building and a lift for people who use wheelchairs and pushchairs. There are local train stations close to the practice as well as good bus services.

The dental team includes one dentist, one dental nurse and two dental hygienists (one currently on maternity leave). The practice has two treatment rooms.

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 feedback from 48 patients through CQC comment cards filled in by patients and speaking with patients. This information gave us a positive view of the practice.

During the inspection we spoke with the dentist and the dental nurse. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Fridays from 8.30am to 6.00pm.

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 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.

Fleet Street Dental Centre ensured that people using the service were respected and involved in their care. Staff were aware that some patients were particularly anxious of visiting the dentist and took extra care to help put patients at ease. We spoke with one patient who said their questions were fully answered. They said they were very pleased with their consultation and said their treatment was fully explained. They told us they were confident that their ongoing course of treatment would be carried out be staff who were knowledgeable and skilled at doing their job. This reflected similar views of the majority of patients who took part in the centre's annual survey.

Most of the patient comments indicated that the service was excellent at advising them how look after their teeth and patients were happy with the results of their treatment. People were protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines safely. The dental centre was clean and there were systems to ensure people were protected from the risks of infection.