We carried out an announced comprehensive inspection on 20 January 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.

Healthy Smiles Dental Practice is a general dental practice close to Leagrave railway station offering private dental treatment to adults and children on Fridays (or other times by appointment only). The principal dentist has a special interest in endodontics (root canal treatment) and accepts referrals from other practices on that basis.

The premises are located all on ground level in converted residential premises and has parking available. The practice consists of one treatment room, a reception and waiting area. There is also a designated decontamination room.

The staff at the practice consists of the principal dentist and two dental nurses (who also work part time at the provider’s other practice in Leagrave). 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.

Our key findings were:

• There was an induction and training programme for staff to follow which ensured they were skilled and competent in delivering safe and effective care and support to patients.
• The practice ensured staff maintained the necessary skills and competence to support the needs of patients.
• There were effective systems in place to reduce the risk and spread of infection. We found the treatment room and equipment were visibly clean.
• There were systems in place to check equipment had been serviced regularly, including the autoclave, fire extinguishers, oxygen cylinder and the X-ray equipment.

• We found the dentist regularly assessed each patient’s gum health and took X-rays at appropriate intervals.

• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available.

• Patients received clear explanations about their proposed treatment, its costs, benefits and risks and were involved in making decisions about it.

• Patients were treated with dignity and respect and confidentiality was maintained.

• The appointment system met the needs of patients.

• Although the practice had not received any complaints, they had an appropriate complaints procedure in place.

• Staff demonstrated knowledge of the practice whistleblowing policy and were confident they would raise a concern about another staff member’s performance if it was necessary.

• At our visit we observed staff were caring, friendly and professional.

• We received feedback from 11 patients who reported they received clear explanations of their treatment options from caring, friendly and professional staff.

• There was an effective system in place to act on feedback received from patients and staff.

• There were systems in place to assess, monitor and improve the quality of service provided.

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 protocols for mitigating risks associated with Legionella by ensuring the practice undertakes a Legionella risk assessment and implements the required actions giving due regard to guidelines issued by the Department of Health - Health Technical Memorandum01-05: Decontamination in primary care dental practices and The Health and Social Care Act 2008: ‘Code of Practice about the prevention and control of infections and related guidance.

• Review the practice protocols for the maintenance of the dental air compressor to ensure it is serviced in line with the manufacturer’s instructions.

During our visit to Healthy Smiles Dental Practice on 31 May 2013, the people we spoke with said they received very good explanations and advice about their care from the dentist. They told us they felt very involved in the discussions around their dental care. People said they felt the surgery was very modern, well maintained and clean. They said they had confidence in the dentist's abilities and knowledge and had never needed to complain about the service. One person said: "He is an accomplished dentist with a sympathetic manner. I feel very relaxed and safe on visiting this practice." Another person said: "I think it's an excellent and professional service. I shall try to persuade others to use it."

During our visit we found each individual's chronology of treatment and any significant discussions had with them to be well documented. We found that each individual had their medical history and any risk factors specific to them reviewed and recorded. We saw that arrangements were in place to deal with foreseeable emergencies, including the provision of items for use in an emergency. We found that staff were appropriately registered and receiving professional development relevant to their roles. We saw the environment was clean and adequate infection control procedures were in place and adhered to by staff.

We found the service had a complaints system in place and information about the procedure was readily available to people who use the service.