We carried out this announced inspection on 25 July 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 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

One One Nine Family Dental Care is in the London Borough of Wandsworth and provides NHS and private treatment to adults and children.

The practice is set out over two levels (ground floor and basement). There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice on surrounding roads.

The dental team includes seven dentists, three dental nurses, one trainee dental nurse, two dental hygienists, a practice manager and an assistant practice manager.

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 six CQC comment cards filled in by patients.

During the inspection we spoke with three dentists, one dental nurse, one dental hygienist, the practice manager and the assistant practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday to Thursday 8.00am to 6.00pm and Fridays 8.00am to 3.00pm.

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 staff 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.
• 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 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.

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

• Review and improve staff awareness of Accessible Information Standards

We spoke with people using the service, they told us that they were made fully aware of the treatment options available to them. One person told us "the costs are always explained up front". The practice had a range of consent forms for different treatment plans. A copy of the signed treatment plan and consent was given to the person using the service.

The equipment used at the practice was clean and the surrounding areas, such as waiting room, offices and treatment rooms were also clean. The practice had policies and checks in place for the monitoring of infection control, water and suction line disinfection, and cleaning. In addition, risk assessments were in place to identify hazards and clinical waste was managed through a waste disposal contractor.

We spoke with staff about their training needs. They told us that the practice encouraged them to attend training courses. One staff member told us "the managers are very supportive".

The practice regularly sought the views of people using the service in the form of an opinion box and surveys. The provider responded to complaints in an appropriate manner.