We carried out an announced comprehensive inspection on 08 November 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

Perfect Smile Healthcare SDS is located in the London Borough of Ealing and provides NHS and private dental treatment to both adults and children. The current premises are on the ground floor and consist of two treatment rooms, an X-ray room and a decontamination room.

The practice is currently undergoing refurbishment. We were told that once the refurbishment is completed the premises will have six treatment rooms, two recovery rooms, a decontamination room, an X-ray room and the reception area.

The practice is open Monday to Thursday 8:00am – 8:00pm, Friday 8:00am – 6:00pm, Saturday 9:00am – 2:00pm and Sunday 10:00am – 4:00pm.

The staff consist of six associate dentists, four dental nurses, a trainee dental nurse, two receptionists and a practice manager.

One of the Directors 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.

We reviewed 22 CQC comment cards, the NHS Friends and Family test and the practice patient satisfaction survey. Patients were positive about the service. They were complimentary about the friendly and caring attitude of the staff.

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

Our key findings were:

• There were appropriate equipment and access to emergency drugs to enable the practice to respond to medical emergencies. Staff knew where equipment was stored.
• We found the dentists regularly assessed each patient’s gum health and took X-rays at appropriate intervals.
• Patients were involved in their care and treatment planning so they could make informed decisions.
• There were effective processes 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 child protection.
• Equipment, such as the autoclave (steriliser), fire extinguishers, and X-ray equipment had all been checked for effectiveness and had been regularly serviced.
• Patients were treated with dignity and respect and confidentiality was maintained.
• The practice had implemented clear procedures for managing comments, concerns or complaints.
• Patients indicated that they found the team to be efficient, professional, caring and reassuring.
• Patients had good access to appointments, including emergency appointments, which were available on the same day.
• Leadership structures were clear and there were processes in place for dissemination of information and feedback to staff.
• 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 areas where the provider could make improvements and should:

• Review the practice’s arrangements for receiving and responding to patient safety alerts, recalls and rapid response reports issued from the Medicines and Healthcare products Regulatory Agency (MHRA) and through the Central Alerting System (CAS), as well as from other relevant bodies such as, Public Health England (PHE).
• 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 safeguarding staff training ensuring it covers both children and adults and all staff are trained to an appropriate level for their role and aware of their responsibilities.
• Review the storage of records related to people employed and the management of regulated activities giving due regard to current legislation and guidance.
• Review the protocols and procedures to ensure staff are up to date with their mandatory training and their Continuing Professional Development.

We spoke with six patients, comments included, “this is my second visit and the service is good, the dentist explained what needed doing, the fees have been explained”. A patient said, “I was referred by my own dentist to have a procedure under sedation, the procedure has been explained to me and I am happy”.

One patient told us the appointment system worked very well. They confirmed they often got a same day appointment if needed. They commented that,” sometimes there is a little delay in being seen but this is usually not a problem as staff always give me information on how long I have to wait”.

Patients confirmed that staff were polite, friendly and one patient told us they had no complaints.