We carried out this announced inspection on 31 May 2018 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.

We told the NHS England area team that we were inspecting the practice. They 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

Northumberland Heath Dental Practice is in Erith in the London borough of Bexley. The practice provides NHS and private treatment to patients of all ages.

There is level access via an entrance at the rear of the practice for people who use wheelchairs and those with pushchairs. Car parking spaces are available in the immediate vicinity of the practice.

The dental team includes ten dentists (one of whom is a specialist prosthodontist), a practice manager, four qualified dental nurses, a trainee dental nurse, two dental hygienists, two receptionists and an administrator.

The practice has four treatment rooms.

The practice is owned by a partnership 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 Northumberland Health Dental Practice was one of the principal dentists.

On the day of inspection, we obtained feedback from 36 patients.

During the inspection we spoke with the practice manager, the principal dentists, two dental nurses, the trainee dental nurse and a receptionist. We checked practice policies and procedures and other records about how the service is managed.

The practice is open from 8.30am to 1pm, and from 2pm to 6pm Monday to Friday. They are open from 9am to 2pm on Saturdays.

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 suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• 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 practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and a culture of continuous improvement.
• 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.
• The practice had suitable information governance arrangements.

We spoke with some people who used the service who had recently received treatments from the dentist. Each person we spoke with told us they were happy with the care and treatment they had been provided with. One person told us they were "very pleased" with the service they had received. People told us they had been given different treatment options by the dentist and that they had been provided with sufficient information to enable them to make a decision, including any relevant costs. People told us they felt the staff were friendly and courteous and one nervous person told us they had been made to feel comfortable. We heard that people felt the surgery was clean including the areas they received treatment in.

We found that people were provided with relevant information about their treatment options and they were afforded the time to make a decision that met their needs. People received treatment after an examination and people's medical history was checked to ensure they received care safely. There were appropriate emergency procedures in place including resuscitation equipment and drugs. We found the provider followed relevant infection control protocols including appropriate processes for the decontamination of instruments. Staff we spoke with told us they felt supported and we found training and team meetings supported this. We found the provider maintained appropriate records relating to people's treatments and the management of the surgery.