We carried out this announced inspection on 24 April 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

Romford Smile Dental Practice is in Romford in the London Borough of Havering and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available at the front of the practice.

The dental team includes four dentists, two dental hygienists, four dental nurses, one of whom is also the practice treatment coordinator and two receptionists, one of whom is the practice manager. 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 27 patients.

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

The practice is open:

Mondays 8am to 8pm

Tuesdays and Thursdays 8am to 6pm

Wednesdays 8am to 7pm

Fridays 8am to 5pm

Saturdays 9am to 3pm

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 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 was an area where the provider could make improvements. They should:

Review the practice’s protocols to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated.

People who used the service understood the care and treatment choices available to them. Comments included "the dentist explains what's going to happen" and "(they) always ask me if I don't understand anything." They said they were happy with the care and treatment they received. Comments included "they treat me very well" and "I find the service very good."

There were effective systems in place to reduce the risk and spread of infection. People said they were satisfied with the cleanliness of the environment and the hygiene practices of staff. Comments included "(the dentist) is very clean, I can't fault that" and "I usually hate going to dentists but I'm very happy with the hygiene here." We found the premises to be visibly clean during the inspection.

Staff received appropriate professional development. People said they had confidence in the abilities of nurses and dentists. Comments included "they seem knowledgeable, I trust them."

The provider had a complaints system in place. We saw information openly displayed referring to the complaints policy. People we spoke with said they had not had cause to make a complaint about the service.