We carried out an announced comprehensive inspection on 16 February 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.

Background

Newbury Smile Studio is a small dental practice offering private dental treatment to adults and children. Newbury is a market town in Berkshire. There are two dental surgeries, one is situated on the ground floor the other surgery is located on the first floor. There is level access from the street. Approximately 500 patients are registered at the practice. The majority of patients are adults.

The staff structure of the practice consisted of two dentists, two visiting specialist dentists, one dental hygienist, two dental nurses/receptionists and one dental nurse/practice manager/receptionist. The practice facilities include two treatment rooms, one consultation/recovery room, one reception and waiting area, and a decontamination room.

The practice is open Monday to Friday from 9am to 5pm. The practice will open outside of these hours by arrangement with individual patients. There was an answer phone message directing patients to emergency contact numbers when the practice is closed.

The practice principal/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.

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

We obtained the feedback of three adult patients and four children on the day of our inspection and Seventeen patients who had completed comment cards. Two patients contacted CQC directly to leave feedback about the practice. We also read patient testimonials on the practice website. All patients comment cards, feedback and testimonials were positive about the care they received from the practice. They were complimentary about the friendly, professional and caring attitude of the dental staff and the dental treatment they had received.

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.
• There was a lead staff member for safeguarding patients. All staff understood their responsibilities for safeguarding adults and children living in vulnerable circumstances.
• 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 they felt they were listened to and that they received good care from the practice team.
• The practice had implemented procedures for managing comments, concerns or complaints.
• Patients could access treatment and urgent and emergency care when required.
• Patients could book appointments up to 12 months in advance.
• The provider had a clear vision for the practice and staff told us they were supported by the practice principal.
• Staff had been trained to handle emergencies and appropriate medicines and life-saving equipment were readily available in accordance with current guidelines.
• The practice appeared clean and well maintained.
• Staff reported incidents and kept records of these which the practice used for shared learning.
• The service was aware of the needs of the local population and took these into account in how the practice was run.
• Staff received training appropriate to their roles and were supported in their continuing professional development by the practice principal.
• Staff we spoke with felt supported by the practice principal and were committed to providing a quality service to their patients.
• The practice offered an Implant treatment service to patients. Following referral the service was carried by a specialist dentist, who attended the practice to carry out the implant treatment.
• Conscious sedation was carried out in accordance with current guidelines from the Society of the Advancement of Anaesthesiology in Dentistry (SAAD).

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

• Review the practice recruitment policy and procedures relating to Disclosure and Barring Service (DBS) checks for staff.
• Review the practice fire risk assessment and consider patients who are undergoing conscious sedation in the practice.
• Review the practice arrangements relating to the provision of a hearing loop for those hard of hearing, signage to indicate the emergency alarm cord in the accessible toilet in case of an emergency and access to translation services for those for whom English is not a first language.
• Review the system of capturing patient feedback and consider how to inform patients of changes made as a result of surveys and feedback.
• Review the location of the equipment and medicines held for medical emergencies.