We carried out an announced comprehensive inspection on 10 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

Angel Smile Dental Care and Orthodontics located in Islington London, provides private dental treatment to patients of all ages.

Practice staffing consists of the principal dentist, three associate dentists, one hygienist, four dental nurses, three trainee dental nurses and one receptionist.

The principal dentist is the registered manager. A registered manager is a person who is registered with the Care Quality Commission 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 practice is open Monday to Thursday 8.30am to 7pm Friday 8.30am to 5.30pm and Saturday 9am to 5pm

The practice facilities include two treatment rooms, a reception and waiting area, decontamination room, office and staff room/kitchen.

20 patients provided feedback about the service. Patients we spoke with and those who completed comment cards were very positive about the care they received from the service. Patients told us that they were happy with the treatment and advice they had received.

Our key findings were:

• Staff had received safeguarding children and adults training and knew the processes to follow to raise any concerns. The practice had whistleblowing policies and procedure and staff were aware of these and their responsibilities to report any concerns.
• There were systems in place to reduce the risk and spread of infection. Dental instruments were cleaned and sterilised in line with current guidance.
• The practice had a procedure for handling and responding to complaints, which were displayed and available to patients.
• Patients were treated with dignity and respect and confidentiality was maintained.
• Patients received clear explanations about their proposed treatment, costs, benefits and risks and were involved in making decisions about it.
• Equipment, such as the autoclaves, fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• 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).
• The practice sought feedback from patients about the services they provided and acted on this to improve its services.

• Governance systems were effective and there were a range of policies and procedures in place which underpinned the management of the practice. Clinical audits were carried out to monitor the quality of services.
• Staff had been trained to handle medical emergencies, and appropriate medicines and life-saving equipment were readily available.

We were unable to speak to any patients at the time of the inspection visit. However feedback forms collected at the practice indicated that people’s treatment options and costs were explained to them and their privacy and dignity were respected. They were able to book appointments at times convenient to them, and were usually seen promptly by dental staff. They were positive about their dentists’ skills, the practice environment, the knowledge and friendliness of staff and quality of photographs and x-rays taken and information provided.

The clinic environment was clean with processes in place to maintain the hygiene of treatment rooms and instruments between each patient.

Appropriate records were kept of each appointment including initial assessments and medical histories.

Appropriate quality assurance procedures were in place for the practice, however people would benefit from improvements to record keeping regarding people’s consent to treatment, recruitment checks and training records, and health and safety records.