We carried out this announced inspection on 16 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

SE1 Dental Centre Practice is based in Lambeth and provides private treatment to patients of all ages.

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

The dental team includes five dentists, three dental hygienists, four dental nurses, one receptionist and one 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 collected 29 CQC comment cards filled in by patients; we also spoke with three patients.

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

The practice is open:

• Monday 8.30am to 6.00pm
• Tuesday 8.30am to 5.00pm
• Wednesday 9.30 am to 8.00pm
• Thursday 8.15am to 5.00pm
• Friday 8.30am to 4.00pm
• Saturday 9.00am to 2.30pm

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. Although improvements could be required in regards to sedation guidance.
• 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.

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

• Review the practice’s system for recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review staff training to ensure that all staff carrying out or assisting with dental procedures carried out under conscious sedation have the appropriate training and skills to carry out the role, taking into account guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015. The provider should also gain documentary evidence as to the competencies and training of people delivering conscious sedation.

• Review the practice’s protocols for conscious sedation, taking into account guidelines published by The Intercollegiate Advisory Committee on Sedation in Dentistry in the document 'Standards for Conscious Sedation in the Provision of Dental Care 2015.

• Review the practice's protocol and staff awareness of their responsibilities under the Duty of candour to ensure compliance with The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

There were three people receiving care at the time of our inspection. We spoke with two of them. They told us that they were very happy and satisfied with the service provided by the surgery. One person said “all the staff here are very friendly, very open and there is a very good atmosphere.” They always found the surgery to be clean whenever they visited and said their treatment plan and expenses had been explained to them before the start of their treatment. The other person we spoke with said they had found their care to be “very effective.”

We found that the people received treatment which was based on an assessment of their needs. Staff were supported in their professional development, and clinical and other records were stored securely. We found the surgery to be clean at the time of our visit and staff mostly followed recommended guidance and appropriate protocols to protect people against the risks of infection