We carried out this announced inspection on 25 June 2018 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. The inspection was led by a CQC inspector who was supported by a specialist dental adviser.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

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 Kensington is in the Royal Borough ofKensingtonand Chelsea, West London and provides NHS and private treatment to patients of all ages.

There is level access for people who use wheelchairs and those with pushchairs. The practice has nearby parking.

The dental team includes four dentists, a dental hygienist, a dental therapist, a receptionist and an area manager who is undertaking the duties of a practice manager until a recently recruited practice manager takes up their role. The practice has two treatment rooms.

The practice is owned by an individual who is the principal dentist there. They have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

On the day of inspection, we collected 19 CQC comment cards filled in by patients.

During the inspection we spoke with a dentist ( who works as a hygienist at the practice), a dental nurse, a receptionist and the area manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open:

• Monday 9.00am to 8.00pm
• Tuesday 9.00am to 5pm
• Wednesday 9.00 am to 8.00pm
• Thursday 9.00am to 6.00pm
• Friday 8.00 am to 5.00pm
• Saturday 9.00am to 1.00pm

Our key findings were:

• The practice appeared clean and well maintained.
• The practice had infection control procedures which reflected published guidance.
• Staff knew how to deal with emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to help them manage risk.
• The practice had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had staff recruitment procedures. However, improvements were required.
• The clinical staff provided patients’ care and treatment in line with current guidelines.
• Staff treated patients with dignity and respect and took care to protect their privacy and personal information.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had good leadership, but improvements were required in regards to developing a culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.
• The practice asked staff and patients for feedback about the services they provided.
• The practice dealt with complaints positively and efficiently.
• The practice had suitable information governance arrangements.

There were areas where the provider could make improvements. They should:

• Review the practice's recruitment policy and procedures to ensure accurate, complete and detailed records are maintained for all staff.

• Review the practice’s audit protocols to ensure audits of various aspects of the service, such as radiography and infection prevention have documented learning points that are shared with all relevant staff and the resulting improvements can be demonstrated.

• Review the current staffing arrangements to ensure all dental care professionals are adequately supported by a trained member of the dental team when treating patients in a dental setting considering the guidance issued by the General Dental Council.

• Review the practice’s protocols for the use of rubber dam for root canal treatment taking into account guidelines issued by the British Endodontic Society.