Archived: Sunny Smiles Dental Innovations - Brentwood

We carried out this announced comprehensive inspection on 16 February 2023 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 practice 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 advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 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:

• The dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were mostly available. Following the inspection, the provider confirmed some of those items missing had been purchased.
• The practice systems to help them manage risk to patients and staff were not robust or effective. Specifically, fire safety and risk assessments to minimise the risk that could be caused from substances that are hazardous to health.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• Patient dental care records did not comply with recommended guidance.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Not all the required radiation protection information was available for the X-ray equipment or the cone-beam computed tomography (CBCT).
• Evidence of the provider operator training for the CBCT and the required 5 hours Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) training for the dentist were not available.
• The appointment system worked efficiently to respond to patients’ needs. Although the dentist was only available for 2 days, the practice was open to book patient appointments and to refer to other local practices for emergency appointments when the dentist was not available.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• There was no system to ensure that required audits of disability access and radiographs or other audits including antibiotic prescribing were undertaken at recommended intervals and used to improve the quality of the service.
• Staff felt involved, supported and worked as a team.
• Staff and patients were asked for feedback about the services provided.
• Complaints were dealt with positively and efficiently.
• The dental clinic had some information governance arrangements.

Background

Sunny Smiles Dental Innovations - Brentwood is in Brentwood, Essex and provides private dental care and treatment for adults and children.

The service is situated on the first floor of a high street premises. People who use wheelchairs and those with pushchairs are referred to a local sister practice with step free access. Car parking spaces, including dedicated parking for disabled people, are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 1 dentist, 2 dental nurses, 1 dental hygienist, 1 practice manager, 1 cleaner and 1 receptionist. The practice has 1 treatment room.

During the inspection we spoke with 1 dentist, 1 dental nurse, 1 receptionist and the practice manager. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open:

Monday from 9am to 6pm for reception only.

Tuesday from 8.45 to 6pm for dental appointments.

Wednesday from 9am to 5pm for hygienist appointments.

Thursday from 9am to 3.30pm for dental appointments.

Friday from 9am to 4pm for reception only.

We identified regulations the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care.

Full details of the regulation the provider is not meeting are at the end of this report.

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

• Take action to ensure audits of disability access and radiographs are undertaken at regular intervals to improve the quality of the service. Practice should also ensure that, where appropriate, audits have documented learning points and the resulting improvements can be demonstrated. In addition; implement audits for prescribing of antibiotic medicines taking into account the guidance provided by the College of General Dentistry.
• Implement protocols for the use of closed-circuit television cameras taking into account the guidelines published by the Information Commissioner's Office.
• Take action to ensure clinicians record in the patients’ dental care records or elsewhere, the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017.