We carried out this announced inspection on 12 September 2017, 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

Osterley Dental Practice is in London Borough of Hounslow and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs.

The dental team includes five dentists, two dental nurses and one receptionist. The practice has three treatment rooms.

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 received feedback from 18 patients. This information gave us a positive view of the practice.

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

The practice is open:

• Monday: 9:00am to 5:00pm

• Saturday: 9:00am to 1:00pm

Our key findings were:

• The practice was clean and well maintained.
• The practice had infection control procedures that 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 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 appointment system met patients’ needs.
• The practice had effective leadership. Staff felt involved, 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.

We found areas where the provider could make improvements and should:

• Review the storage of dental care products and medicines requiring refrigeration to ensure they are stored in line with the manufacturer’s guidance and the fridge temperature is monitored and recorded.
• Review availability of equipment to manage medical emergencies taking into account guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• 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.

We spoke with four patients who confirmed they all had their history taken before each appointment. All the patients we spoke with were happy with the treatment and care they received.

They were all given choices in what treatment they wanted if there was a choice available and the success rates and risks of each treatment. The prices were explained to them although we only spoke to NHS patients on the day. They said the treatment they were going to have was explained to them. Oral health advice was given to each patient including advice that was specific for them including diet.

Patient’s that were attending for routine appointments but had other issues to discuss were observed as having those resolved or start to be resolved that day.

Patients were happy with the appointment booking process including getting emergency appointments on the same day. The most anyone had to wait past their appointment time for an appointment was 10 to 15 minutes.

Patients said they would recommend the service, saying the dentist and staff were ‘wonderful’ and ‘does the job properly’ with one patient who was previously anxious when coming to the dentist saying they ‘take care of her’.

Patients said the service was clean.

We observed that the staff could speak different languages to the patients.