We carried out an announced comprehensive inspection on 20 October 2015 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

Eternal Smiles Dental Centre provides general dental services predominantly on a private basis (fee per item) although they do hold a small NHS contract (30%). The services provided include predominantly routine restorative and preventative dental treatment but also implants. The service is provided by the practice owner (provider). They are supported by one dental nurse, one receptionist and a practice manager. The practice is located on the first floor in a building in the heart of Solihull town centre. There is a staircase leading to the first floor and there is no access to facilities for patients who are disabled or those with limited mobility. There is a waiting room, two treatment rooms, a decontamination room, a reception area, a storage room and toilet facilities. The practice is located close to local amenities and bus services and there is a car park close to the practice. The practice opens from Monday to Saturday at 9am. Closing times vary throughout the week from 3pm to 7pm.

The provider is the registered manager. A registered manager is a person who is registered with the Care Quality Commission (CQC) 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.

30 patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with patients on the day of the inspection. Overall the information from patients was very positive. Patients were positive about their experience and they commented that they were treated with care, respect and dignity. Staff told us that they always interacted with them in a respectful, appropriate and kind manner. Some patients told us the practice did not always provide them with a written treatment plan.

Our key findings were:

• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained. They had access to an automated external defibrillator (AED). An AED is a portable electronic device that analyses life threatening irregularities of the heart including ventricular fibrillation and is able to deliver an electrical shock to attempt to restore a normal heart rhythm.
• The practice had systems to assess and manage risks to patients, including infection prevention and control, health and safety, safeguarding and the management of medical emergencies.
• Staff received training appropriate to their roles.
• Patients told us they were treated with respect and dignity by staff. Staff ensured there was sufficient time to explain fully the care and treatment they were providing in a way patients understood. Patients commented they felt involved in their treatment and that it was fully explained to them.
• Patients were able to make routine and emergency appointments when needed.
• The practice had an effective complaints system in place and there was an openness and transparency in how these were dealt with.
• Staff told us they felt well supported and comfortable to raise concerns or make suggestions.
• Audits were undertaken regularly but were not always complete as action plans were not always documented.

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

• Review the practice’s protocols for the use of rubber dam for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.
• Review the practice's protocols for completion of dental records giving due regard to guidance provided by the Faculty of General Dental Practice (FGDP) regarding clinical examinations and record keeping.
• Check all audits have learning points documented and resulting improvements can be demonstrated.
• Review the practice's recruitment policy and procedures to ensure character references for new staff as well as proof of identification are requested, reviewed and recorded suitably.
• Maintain minutes for staff meetings as they are useful review documents for staff to reference at a later date.
• Maintain a business continuity plan that is comprehensive and specific to this practice.
• Make arrangements so that the practice has access to an interpreting service for patients who cannot speak English (or any other language spoken by the provider).

During our visit on 27 July we spoke with the provider who is the dentist for the practice, a dental nurse and the receptionist.

We spoke to six people who had attended Eternal Smiles Dental Centre. They all gave positive feedback about the service they had received. They told us, “It’s an excellent dentist, everyone is really friendly” and “The dentist explained everything to me so I understood exactly what he was going to do.”

People told us that they were able to make an appointment quite easily and did not have to wait very long to see the dentist when they arrived. One person said “I don’t have to wait long at all, not more than five minutes at the most.”

People we spoke with told us everything was always explained to them. One person told us “The treatment options were fully explained to me. I was shown the x rays and what needed to be done."

People we spoke with said that everything in the practice always looked clean and tidy. One person said “The surgery has always been spotlessly clean when I’ve visited.”

We asked people about making a complaint. People said, "I have never had any reason to complain but I would speak to the dentist if I was unhappy with anything."

All the people we spoke with were happy with the service they received. we were told “I am more than happy with the service they provide.” “All the staff are very friendly and the dentist is extremely professional.”