We carried out an announced comprehensive inspection on 23 March 2016 to ask the practice the following key questions; Are services safe, effective, caring, responsive and well-led?

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

Tooting Bec Dental is a dental practice located in the London Borough of Wandsworth. The premises are on the ground floor of a building in a high-street location. There are two treatment rooms, although only one is currently in use. There is also a dedicated decontamination room, X-ray room, reception with waiting area, and a patient toilet.

The practice provides private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers, extractions, crowns and bridges as well as specialist services, such as dental implants and conscious sedation.

The staff structure of the practice consists of two principal dentists, an associate implantologist and two trainee dental nurses. The practice was also in the process of recruiting specialists in endodontics and orthodontics at the time of the inspection.

The practice opening hours are from 9.00am to 6.00pm Monday to Friday and from 9.00am to 5.00pm on Saturday.

One of the principal dentists was the registered manager. A registered manager is a person who is registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons 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 inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Fifteen people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• Patients’ needs were assessed and care was planned in line with current guidance such as from the National Institute for Health and Care Excellence (NICE).

• There were effective systems in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances. However, although all clinical staff had had some safeguarding training, this was not always to the recommended level.
• Staff knew how to report incidents and forms were available to keep a record of any incident which could be used by the practice for shared learning.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

There were areas where the provider could make improvements and should:

• Review availability of equipment for managing medical emergencies giving due regard to guidelines issued by the Resuscitation Council (UK), and the General Dental Council (GDC) standards for the dental team.
• Review staff training to ensure that all of the staff had undergone relevant training, to an appropriate level, in the safeguarding of children and vulnerable adults.
• Review its audit protocols to ensure infection control audits are undertaken at regular intervals and, where applicable, learning points are documented and shared with relevant staff.
• Review its responsibilities as regards to the Control of Substance Hazardous to Health (COSHH) Regulations 2002 and, ensure all documentation is up to date and staff understand how to minimise risks associated with the use of and handling of these substances.
• Review the protocols for obtaining and maintaining accurate, complete and detailed records relating to staff employed for the purpose of carrying on the regulated activities, giving due regard to current legislation and guidance.