We carried out this announced inspection on 4 March 2019 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

Ten Dental (Balham) provides private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. The practice had nearby parking facilities.

The dental team includes twelve dentists, five dental nurses, two receptionists, two hygienists and an area manager. The practice has four treatment rooms.

The practice is owned by a company 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. One of the principal dentists was the registered manager.

We received feedback about the service from 4 patients.

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

The practice is open:

Monday -Thursday 8.30 to 8pm

Friday 8.30 to 5.30pm

Saturday 9.00 to 5.00pm

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 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 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 current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting considering the guidance issued by the General Dental Council.

• Review its responsibilities to meet the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.

• Review current policies and procedures for obtaining patient consent to care and treatment and ensure they reflect current legislation and guidance, and that staff follow them at all times.

• Review the current Legionella risk assessment and ensure it is in line with current guidelines.

During our visit on the 6 February 2014 we spoke with people who used the service, clinical and non-clinical staff and looked at records.

People who used the service told us, “they are very welcoming here”, “always charming” and “you are given plenty of information about your treatment”.

Ten Dental was based on the ground and lower floors of a building. People with mobility concerns could be seen in the ground floor clinical room. There were two clinical rooms, a separate decontamination room, a spacious reception area and a separate consultation room. We saw that people were spoken to in a friendly and quiet manner and their privacy was maintained.

The practice was clean and well maintained, equipment regularly serviced, treatment plans held securely and staff appropriately trained and qualified.