We carried out an announced comprehensive inspection on 21 February 2017 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

Aesthetic Smiles is a dental practice providing private and NHS care for adults and children. Where private treatment is provided some is under a fee per item basis and some under a dental insurance plan. The practice is situated in a converted property with patient facilities on the ground and first floor.

The practice has four dental treatment rooms; one on the ground floor and three on the first floor. There is a dedicated X-ray room on the first floor. There is also a reception and waiting area and other rooms used by the practice for office facilities and storage. The practice is open from 8.00am to 6.00pm from Monday to Thursday and from 8.00am to 1.00pm on Fridays.

The practice has two full time dentists and one part time dentist. They are supported by three dental nurses, a trainee dental nurse, a part time dental hygienist, a practice manager and two dedicated receptionists.

The practice are able to provide general dental services including endodontic (root canal) treatment, orthodontic treatment, implants, minor oral surgery and some cosmetic dentistry.

The practice also provides the option of treatment under conscious sedation and the expected arrangements are in place to do this safely. Conscious sedation is the use of medicines to reduce alertness and help the patient relax but still be able to hear and respond to the dentist if necessary, while treatment is carried out.

The registered provider is a partnership of the two principal dentists. The registered manager is the practice manager. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

Before the inspection we sent Care Quality Commission comment cards to the practice for patients to complete to tell us about their experience. We also spoke with patients on the day of our inspection. We received feedback from a total of 51 patients. All the feedback was positive with patients commenting favourably on the quality of care and service they received, the professional, efficient and caring nature of staff and the cleanliness of the practice. Patients also commented on the ease with which they were able to make appointments.

Our key findings were:

• Staff reported incidents which were investigated, discussed and learning implemented to improve safety.

• The practice was visibly clean and well maintained and infection control procedures were in line with the requirements of the ‘Health Technical Memorandum 01-05 (HTM 01-05): Decontamination in primary care dental practices’ published by the Department of Health.

• The practice had medicines and equipment for use in a medical emergency which were in accordance with national guidelines.

• Staff had received training appropriate to their roles and were supported in their continued professional development (CPD).

• Patients commented that they were extremely satisfied with the care they received and that staff were helpful, kind caring and courteous. They also said they were able to get appointments easily and at times convenient to them.

• The practice had good facilities and was equipped to treat patients and meet their needs but the practice was not accessible for wheelchair users.

• The practice had suitable facilities and was equipped to treat patients and meet their needs.

• Arrangements for the provision of treatment under conscious sedation were in line with published guidance.

• Governance arrangements were in place for the smooth running of the service.

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

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).

• Review the practice’s sharps procedures giving due regard to the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

People told us that they felt included in any care planning and that their questions or concerns were always listed to before any treatment started. The felt the care provided was safe and that the staff were very professional. They also said that the location was always clean and that the staff always presented themselves in clean uniforms and looked professional at all times.