We carried out this announced inspection on 28 February 2019 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 CQC inspector who was supported by a specialist dental adviser.

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

Bright Smile Dental Practice is in the Carlton area of Nottingham and provides mostly NHS dental treatment and a small amount of private dental treatment to adults and children.

There is level access for people who use wheelchairs and those with pushchairs. There is roadside car parking available close to the practice.

The dental team includes one dentist, one qualified dental nurse, and two receptionists. The practice has two treatment rooms, one of which is on the ground floor.

The practice is owned by a company and as a condition of registration must have a person registered with the Care Quality Commission 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 Bright Smile Dental Practice is the principal dentist.

On the day of inspection, we collected 45 CQC comment cards filled in by patients.

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

The practice is open: Monday to Wednesday from 9am to 5pm, Thursday from 9am to 6pm  and Friday from 9am to 5pm. The practice is closed on Saturday and Sunday.

Our key findings were:

• The practice appeared clean and well maintained.
• The provider had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The information relating to the control and storage of substances hazardous to health needed updating.
• The practice had systems to help them manage risk to patients and staff.
• The fire risk assessment needed review.
• The provider had suitable safeguarding processes and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The provider had most of the staff recruitment information required by the Regulations.
• 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.
• Staff were providing preventive care and supporting patients to ensure better oral health.
• Staff training regarding the Mental Capacity Act and Gillick competence needed review.
• The appointment system took account of patients’ needs.
• Staff felt involved and supported and worked well as a team.
• The provider asked staff and patients for feedback about the services they provided.
• The provider dealt with complaints positively and efficiently.
• The provider had suitable information governance arrangements.
• The radiography audit was overdue. 

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

• Review the practice's policy for the control and storage of substances hazardous to health identified by the Control of Substances Hazardous to Health Regulations 2002, to ensure risk assessments are undertaken and the products are stored securely.

• Review the fire safety risk assessment and ensure that any actions required are complete and ongoing fire safety management is effective.

• Review staff awareness of Gillick competency and ensure all staff are aware of their responsibilities in relation to this.

• Review the practice’s protocols to ensure audits of radiography are undertaken at regular intervals to improve the quality of the service.

People who used the service understood the care and treatment choices available to them. We spoke with three people using the service. They all told us that they were treated with dignity and respect by all of the staff employed at the service. People said clear explanations of the various treatment options and costs were explained to them by the dentist. One person told us: “The staff are brilliant they are very friendly and respectful.” Another person told us that they were able to arrange an appointment for the same day when they needed emergency treatment.

All patients that we spoke with told us that they were satisfied with the standard of care and treatment provided. One person told us: “I have just joined this practice the staff have been very friendly and helpful.” Another person told us: “The dentist gives you information about how to look after your teeth, and explained to me about how to take antibiotic medication.”

People told us that they felt safe when receiving their treatment. One person told us: “I feel safe and cared for by the dentist.” People told us that the practice was clean and hygienic. One person told us: “It seems to be very clean and tidy here.”