We carried out this announced inspection on 4 February 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 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 Hampstead Clinic is in the London Borough of Camden. The practice provides private treatment to patients of all ages.

The practice is located on the first floor of the premises and the layout and design of the building do not afford the provision of step free access. The practice is located close to public transport bus and train services.

The dental team includes the principal dentist who owns the practice, one dental hygienist and two dental nurses. The clinical team are supported by a practice manager.

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. The registered manager at The Hampstead Clinic was the principal dentist.

On the day of inspection we received feedback from 47 patients.

During the inspection we spoke with the principal dentist, one dental nurse, and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open between 9am and 6pm on Mondays to Fridays and between 8am and 4.30pm on alternate Saturdays:

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 with the exception of one medicine which were ordered and received by the practice promptly.
• 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.
• 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 had arrangements to deal with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

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This inspection was a follow up to our inspection on the 13 September 2013, when we judged that the provider was not compliant with the requirements of regulation 19 of the Care Quality Commission (Registration) Regulations 2009 and regulations 9, 12, 19 and 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We had found that the provider did not ensure that patients were protected from the risk of receiving inappropriate care or treatment. The provider did not carry out a full assessment of patients' needs and did not provide patients with treatment plans or cost estimates. The provider did not follow infection control guidance. The provider did not have systems in place to ensure patients’ comments and complaints were listened to or dealt with appropriately. Patients’ records were not always accurate and fit for purpose. The provider did not keep appropriate records relating to the service.

Following that inspection the provider sent us a plan of the actions it intended to take to comply with the regulations. We made this visit to check that the actions had been implemented.

We spoke with the registered manager, practice manager and the practice nurse. We looked at service records and inspected the premises. We found that the provider had taken appropriate and sufficient action and was now compliant with the regulations.

The Hampstead Clinic is a family run clinic offering general and cosmetic dentistry. The clinic employed one dentist, two dental nurses and a dental hygienist who worked once a week. There were two treatment rooms, one used by the dentist and another one by the hygienist. At the time of the inspection the premises were shared with the Skin Clinic. This report relates only to the services provided under the registration for The Hampstead Clinic.

Patients told us that they would recommend the surgery to friends and family and that they experienced effective treatment. We found that the provider did not ensure that patients were protected from the risk of receiving inappropriate care or treatments.

The provider did not carry out a full assessment of patient’s needs. They did not provide patients with treatment plans or cost estimates.

Patients were treated in a clean environment, However, the provider did not follow infection control guidance.

The provider did not have systems in place to ensure patients’ comments and complaints were listened to and dealt with appropriately.

Patients’ records were kept securely and remained confidential, however, they were not always accurate and fit for purpose. The provider did not keep appropriate records relating to the management of the regulated activity.