We carried out an announced comprehensive inspection on 26 July 2016 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

Brightsmile Dental Care Limited – Kingston is located in the London Borough of Kingston-Upon-Thames. The premises are situated in a converted residential building. There are six treatment rooms, a reception room with waiting area, two other waiting rooms, an X-ray room, two decontamination rooms, patient toilets, a staff room and a range of administrative offices. These are distributed across the lower ground, ground and first floors of the building.

The practice provides NHS and private services to adults and children. The practice offers a range of dental services including routine examinations and treatment, veneers and crowns and bridges.

The staff structure of the practice consists of a principal dentist, an operational director, a practice manager, eight associate dentists, a hygienist, five dental nurses, two trainee dental nurses, and three receptionists

The practice opening hours are Monday to Thursday from 9.00am to 6.00pm, from 9.00am to 4.00pm on Friday and from 9.15am to 4.15pm on Saturdays.

The operational director 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 inspection took place over one day and was carried out by a CQC inspector and a dental specialist advisor.

Fifty-three people provided feedback about the service. Patients were positive about the care they received from the practice. They were complimentary about the friendly and caring attitude of the dental staff.

Our key findings were:

• 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).

• There were effective systems in place to reduce and minimise the risk and spread of infection.
• The practice had effective safeguarding processes in place and staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• There were effective arrangements in place for managing medical emergencies.
• Equipment, such as the air compressor, autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.

• Patients indicated that they felt they were listened to and that they received good care from a helpful and caring practice team.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• The provider had a clear vision for the practice and staff told us they were well supported by the management team.
• Governance arrangements and audits were effective in improving the quality and safety of the services.

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

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

People using the service told us they were very satisfied with the practice, service they received and way it was provided. One person told us "I can't see how anybody could be more satisfied". Another said "Pleasant, efficient and caring". They were given explanations and clarification about the consultation process, reason why treatment was required, available alternative treatments and costs throughout their patient experience. This included any risks that a treatment may involve. They told us they were treated with dignity and respect by staff and felt safe using the service. They also thought there were enough staff who were suitably qualified to meet their needs. People said "A bright surgery, cheerful staff and helpful advice". They were made aware of the complaints procedure and how to implement it if necessary.

They did not comment on the practice infection control systems. They did tell us they thought the practice was kept clean, tidy and observed their right to privacy.