We carried out this announced inspection on 2 May 2019 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 Care Quality Commission CQC inspector who was supported by a specialist dental adviser.

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

Goodmayes Dental Practice Ltd is in Goodmayes in the London borough of Redbridge. The practice provides NHS and private dental treatments to patients of all ages.

The practice is located on the ground floor level in a purpose adapted premises and there are two treatment rooms.. There is step free access to the practice. The practice is located close to public transport services.

The dental team includes the principal dentist, who along with his spouse, also a dentist own the practice, one associate dentist, three dental nurses and one trainee dental nurse. The clinical team are supported a receptionist.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run. The registered manager at Goodmayes Dental Practice Ltd was the principal dentist.

On the day of our inspection we received feedback from 50 patients.

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

The practice is open Monday to Friday between 8am and 5pm.

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 a fire safety procedure, which was reviewed and discussed with staff regularly during practice meetings. Improvements were needed to the systems for recording risks in relation to fire safety and use of hazardous substances.
• 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. Improvements were needed so that dental care records were detailed and complete.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice's environmental risk assessments and ensure a fire risk assessment is undertaken and is kept under review,

• Review the practice’s protocols for recording in the patients’ dental care records or elsewhere the reason for taking the X-ray and quality of the X-ray ensuring compliance with the Ionising Radiation (Medical Exposure) Regulations (IRMER) 2000.
• Review the practice's policy for products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken.
• Review the practice's protocols for completion of dental care records taking into account guidance provided by the Faculty of General Dental Practice regarding clinical examinations and record keeping.
• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography are undertaken at regular intervals to help improve the quality of service. Practice should also ensure that where appropriate audits have documented learning points and the resulting improvements can be demonstrated.

People who used this dental practice told us that they were very pleased with the quality of the service provided. They described the practice as “wonderful” and “brilliant.” People said they were treated with respect. One person said “they are very professional. They treat you appropriately and you have privacy when needed.” People also told us that treatments were clearly explained to them. One person said “they give options that are best for the patient.” Another told us “they clearly explain things and if they can’t do it they make a referral to the hospital.”

Suitable arrangements were in place for cleaning and sterilising dental equipment. We found that people were treated in a safe, clean and hygienic environment. People told us that they were happy with the cleanliness of the practice. One person said “it’s always clean and hygienic, even when they were having work done.”

Staff received the training and support needed to provide a safe and appropriate service that met people’s care and welfare needs. They were aware of their responsibility with regard to safeguarding any children or vulnerable adults who used the service.

People’s records were accurate and up to date providing information about the advice and treatment that they had received. Records were securely stored to ensure that patient confidentiality was maintained.