We carried out an announced comprehensive inspection on 20 October 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

Knowle Smile Spa is a dental practice providing general dental services on a NHS and private basis. The practice also offered dental implants and orthodontic treatment. The service is provided by two dentists (one of whom is the provider) and a hygienist. They are supported by two dental nurses, a practice manager and a receptionist. All of the dental nurses also carry out reception duties.

The practice is located near local amenities and bus routes. There is wheelchair access to the practice and car parking facilities. The premises consist of a waiting room, a reception area, toilet facilities, a decontamination room and three treatment rooms on the ground floor. The first floor comprises of storage rooms, an office, kitchen, staff room and toilet facilities. There is also an area for developing X-rays on the ground floor. There is a basement and this holds the compressor (pressure vessel equipment). The practice is open between 9am and 5:45pm on Monday to Thursday, and between 9am and 5pm on Fridays.

The provider is registered with the Care Quality Commission (CQC) as an individual. 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.

Twenty-two patients provided feedback about the practice. We looked at comment cards patients had completed prior to the inspection and we also spoke with three patients. The information from patients was overwhelmingly complimentary. Patients were positive about their experience and they commented that staff were gentle and caring and the practice was always immaculate.

Our key findings were:

• The practice was organised and appeared clean and tidy on the day of our visit. Many patients also commented that this was their experience.
• Patients told us they found the staff very caring and friendly. Patients were able to make routine and emergency appointments when needed.
• Infection control standards met national guidance.
• The practice had systems to assess and manage risks to patients, including health and safety, safeguarding, safe staff recruitment and the management of medical emergencies.
• Dental professionals provided treatment in accordance with current professional guidelines.
• Staff received training appropriate to their roles.
• There was appropriate equipment for staff to undertake their duties, and equipment was well maintained.
• 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.
• Practice meetings were used for shared learning.
• The practice regularly undertook audits in infection control, radiography and dental care record keeping.

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

• Review the practice’s procedures that identify the servicing and testing requirements of the X-ray equipment to ensure these are carried out in a timely manner.
• Review the X-ray equipment and consider fitting a rectangular collimator to any new X-ray equipment that is installed in future. This was already present on some of the equipment at the practice but not all due to the old design of some of the equipment.
• Review the practice’s procedures for identifying and repairing any defects in the cabinetry in the treatment rooms.

During our visit on 18 December we met with the practice manager, a dentist and a dental nurse.

We spoke with six people who attended the practice. People described the practice as being welcoming and friendly. Most people told us it was “Fantastic.”

People spoke very positively about the quality of the service they had received. One person told us, "They offer a truly personal service." Another said, “I can’t get over the waiting room, it’s amazing.”

People we spoke with told us that everything was always explained to them. One person said, "They treat you like an individual and carefully explain everything."

During our visit we saw the practice was clean and tidy. Processes were in place to ensure that equipment was safe to use and high levels of cleanliness maintained.

The practice had processes in place to monitor people's views about the service offered. People told us they never had cause to complain about the service they had received. People told us they were satisfied with the service and had recommended it to family and friends.