We carried out this announced inspection on 21 August 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

The Ivory Clinic is in the London Borough of Hounslow and provides NHS and private treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces are available in surrounding road.

The dental team includes four dentists, two dental nurses and a business administrator. The practice has one treatment room.

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 two CQC comment cards filled in by patients.

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

The practice is open: Monday and Wednesdays 9.00am to 5.00pm; Tuesdays 8.30am to 4.30pm; Thursdays 10.00am to 6.00pm; Fridays 8.00am to 4.00pm.

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 staff 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.

We spoke with five patients, although two of these were new patients and had not been to the service before. All five patients said they did not have to wait long to get an appointment. One patient had contacted the service on that day to request an emergency appointment and said they were pleased they could be seen the same day. One patient commented “I would come back here”. Another patient told us they were nervous but the dentist had put them at ease and they were happy with how they had been treated. One patient said the staff were “professional and friendly”, whilst another said the staff were “polite”.

Three patients told us the treatment they had received had always been explained to them. They confirmed the dentist had shown them the reason why they needed the treatment and the cost had been told to them.

The two patients we asked said the premises were clean and they had no concerns about the cleanliness of any of the rooms.