We carried out this announced inspection on 20 September 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

Smile 4 Life is located in the David Lane area of Nottingham. The practice is well served by public transport including buses and trams. The practice provides private dental treatment to adults and children.

The practice is located on the first floor of a building and is accessed by using a flight of stairs. Any patients who are unable to climb the stairs will be referred to another practice a short distance away which is fully accessible. There is car parking available at the practice.

The dental team includes a medical director, a dentist, an orthodontist and one dental nurse and one practice manager. The practice has one treatment room which is located on the first floor.

The practice is owned by an organisation and as a condition of registration must have a person registered with the Care Quality Commission as the registered manager. Registered managers 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 practice manager is the registered manager.

On the day of inspection, we received feedback from nine patients.

During the inspection we spoke with one dental nurse, the nominated individual and the practice manager. We looked at practice policies and procedures and other records about how the service is managed.

The practice is open: Monday: Closed, Tuesday: 11.30am to 8pm, Wednesday: 10am to 8pm,

Thursday: Closed, 7.30am to 7pm, Friday: 11.30am to 7pm, Saturday and Sunday: closed.

Our key findings were:

• The practice appeared clean and well maintained.
• The practice staff 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 staff had suitable safeguarding processes and staff knew their responsibilities for safeguarding adults and children.
• The practice had thorough staff recruitment procedures.
• 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 did not have an induction hearing loop to assist patients with hearing loss who used a hearing aid.
• The practice was providing preventive care and supporting patients to ensure better oral health.
• The appointment system met patients’ needs.
• The practice had effective leadership and culture of continuous improvement.
• Staff felt involved and supported and worked well as a team.

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

• Review its responsibilities to the needs of people with a disability, including those with hearing difficulties and the requirements of the Equality Act 2010.