We carried out an announced comprehensive inspection on 02 March 2017 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 G Lai & Associates - Shepherds Bush is located in the London Borough of Hammersmith and Fulham. The practice provides NHS and private dental treatment to both adults and children. The premises are on the ground floor and consist of two treatment rooms, a reception area and a decontamination room. The practice is open Monday - Friday 9:30am – 6:00pm.

The staff consists of the principal dentist, an associate dentist, two dental nurses one of whom is the receptionist.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘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.

We reviewed 12 CQC comment cards and the NHS Friends and Family test. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

The inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.

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

• Review availability of medicines to manage medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• Review the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure they are stored securely.

We spoke with people using the service who told us that their treatment had been "fully explained" and that they "always discuss options" with the dentist. In recent patient feedback, when asked about staff being helpful and knowledgeable, and whether they received adequate information about their treatment the majority of people rated the practice as "good".

People using the service described it as "good" and said that medical histories were taken prior to treatment being provided. In recent patient feedback people said they were "well looked after". Staff had been trained in what to do in a medical emergency. There were emergency drugs and equipment available in the practice.

On the day of the inspection the practice was clean and tidy. There were policies and procedures in place on how to maintain a clean and hygienic environment and staff made regular checks to ensure that these were being followed.

All staff underwent appropriate training on an annual basis in relevant mandatory topics such as medical emergencies and decontamination, as well as training specific to treatments they provided.

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