We carried out an announced comprehensive inspection on 6 July 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Mr. Adam Clapp is located in the City of London and provides private dental services. The opening hours for the practice were Monday to Thursdays 8.30 – 6.00pm and 8.30- 4.00pm Fridays.

The premises consists of four treatment rooms, an X-ray room, a decontamination room and a waiting area.

The practice comprises of a principal dentist, five dentists, four dental nurses, a receptionist and a practice manager.

The principal dentist is registered with the Care Quality Commission (CQC) as an individual registered persons. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the practice is run.

During the inspection we asked patients to complete CQC comment cards. We received 27 comment cards back from patients and spoke with four patients on the day of the inspection. The patients who provided feedback were positive about the care and treatment they received at the practice. They told us they were involved in all aspects of their care and found the staff to be caring, friendly and helpful and they were treated with care, dignity and respect.

Our key findings were:

• There were effective processes in place to reduce and minimise the risk and spread of infection.
• Patients’ needs were assessed and care was planned in line with best practice guidance such as from the National Institute for Health and Care Excellence (NICE) .Patients were involved in their care and treatment planning.
• There was appropriate equipment for staff to undertake their duties and equipment was well maintained.
• Staff were trained in and there was appropriate equipment for them to respond to medical emergencies.
• Patients told us that staff were caring and treated them with dignity and respect.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• There were processes in place for patients to give their comments and feedback about the service including making complaints and compliments.
• There were good governance arrangements and an effective management structure.

There were areas where the provider could make improvements and should:

• Review the protocols for obtaining and maintaining accurate, complete and detailed records relating to staff employed for the purpose of carrying on the regulated activities, giving due regard to current legislation and guidance.

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013

• Review the practice’s audit protocols of various aspects of the service, such as radiography and dental care records at regular intervals to help improve the quality of service. Practice should also check , that where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

• Review staff awareness of the requirements of the Mental Capacity Act (MCA) 2005 and ensure all staff are aware of their responsibilities under the Act as it relates to their role.

• Review the practice’s protocols for medicines management and ensure all medicines stored and dispensed safely and securely.

• Review the protocols and procedures for use of X-ray equipment taking into account guidance notes on the Safe use of X-ray Equipment.

As part of this inspection we spoke with two patients of Mr Clapp, both of whom told us they were satisfied with the quality of treatment and work provided by the surgery. One person described the clinic as “excellent”. Another person commented, “this place is great”.

People experienced care, treatment and support that met their needs and protected their rights. We received positive feedback about the quality of care offered by the clinic. Both people who spoke with us told us that they were provided with a very high quality of care, which was consistent and fully met their needs. One person said, “everyone is lovely and I am very happy.”

People were protected from the risk of infection because appropriate guidance had been followed. People were cared for in a clean, hygienic environment.

People were cared for by staff who were supported to deliver care

and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

As part of our visit we spoke with four patients who used the service, two of whom received treatments from Mr Clapp. We received very positive comments from all patients about the practice in general and the quality of care provided by Mr Clapp. One person, who has been visiting the practice for a number of years, said: 'I would be devastated if the surgery was to close'.