We carried out this announced inspection on 08 November 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 Care Quality Commission (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

The Belmont Dental Centre is in the London Borough of Harrow and provides NHS and private treatment to adults and children.

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

The dental team includes two principal dentists, one dentist and two dental nurses/receptionist.

The practice is owned by an organisation 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. The registered manager at The Belmont Dental Centre was one of the principal dentist

On the day of inspection, we received feedback about the practice from 52 people

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

The practice is open:

• Monday to Thursday 9.00am – 5.30pm
• Friday 9.00am – 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 practice's policy and the storage of products identified under Control of Substances Hazardous to Health (COSHH) 2002 Regulations to ensure a risk assessment is undertaken and the products are stored securely.

We found patients who use the service understood the care and treatment choices available to them. One patient told us the dentist “explains and is always clear about the treatment they are providing and the costs. They also provide good aftercare advice”.

We observed staff following best practice guidelines for surgical instrument decontamination and hygiene. Staff had been trained in infection control and dealing with emergencies to protect patients from risk of harm.

Staff had been trained on safeguarding and showed awareness of reporting procedures. The staff received appropriate support at work. We found staff were qualified to carry out their work and training had been undertaken in line with their professional development requirements.

There were effective systems in place for checking the quality of the service provided, and the provider acted on feedback from patients and made changes to improve the service.