Smile Dental Practice

We carried out this announced inspection on 29 August 2017 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.

We told the NHS England area team and Healthwatch that we were inspecting the practice. They did not provide any information.

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

Day & Senior Dental Practice is in the South East London borough of Bromley. It provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. Car parking spaces, including those for patients with disabled badges, are available near the practice.

The clinical dental team includes four dentists, a head dental nurse, a dental nurse and a trainee dental nurse (both of whom also work as receptionists), a dental hygienist therapist. The non-clinical dental team includes a managing director, a general manager, a practice manafer, two receptionists, and a domestic staff member. The practice has two treatment rooms.

The practice is owned by a company and as a condition of registration must have a person registered with the CQC 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 Day & Senior Dental Practice was the managing director.

On the day of inspection we collected feedback from 13 patients. This information gave us a positive view of the practice.

During the inspection we spoke with two dentists, a dental nurse, a trainee dental nurse, a receptionists, the practice manager, the general manager, and the managing director. We checked practice policies and procedures, and other records about how the service is managed.

The practice is open at the following times:

Monday and Thursday: 9am to 6pm

Tuesday: 9am to 7pm

Wednesday: 8am to 5pm

Friday: 9am to 4pm

Saturday: 9am to 3pm.

Our key findings were:

• The practice was clean and well maintained.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• 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 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 dealt with complaints positively and efficiently.
• The practice had systems to help them manage risk. Improvements could be made to ensure actions identified were implemented.
• Improvements could be made to establish an effective system for reporting, recording and discussing significant events and incidents.
• The practice had infection control procedures. Improvements could be made to ensure the infection prevention and control audit was carried out in accordance with current recommended intervals.

Shortly after the inspection the practice took steps to begin to address the issues we identified.

There were areas where the provider could make improvements. They should:

• Review current arrangements to ensure all actions from risk assessments are reviewed and responded to, and improvements are made as a result.

• Review the practice’s system for recording, investigating and reviewing incidents or significant events, with a view to preventing further occurrences and ensuring that improvements are made as a result.

• Review practice procedures to ensure the infection prevention and control audit is carried out every six months in line with current guidance.